Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Oct 28, 2018
Date Accepted: May 31, 2019
(closed for review but you can still tweet)
Exploring the impact of a mHealth solution for post-partum pelvic health: A randomized controlled feasibility study
ABSTRACT
Background:
The post-partum period is a vulnerable time for the pelvic floor. Early implementation of pelvic floor muscle exercises in the post-partum period has been advocated due to the established effectiveness of this intervention. The popularity of mobile health (mHealth) devices highlights their perceived utility among the public. The advent of various mHealth technologies currently available with claims to support pelvic floor health and fitness, have yet to be substantiated through systematic inquiry.
Objective:
We sought to determine the acceptability, feasibility and potential effect on outcomes of an mHealth solutions purposed to facilitate pelvic floor muscles training among post-partum women.
Methods:
A mixed methods pilot study was conducted to evaluate outcomes after a 16-week intervention period. Quantitative data included measurement of pelvic floor muscle parameters (strength, endurance, and co-ordination); Incontinence Impact Questionnaire (IIQ-7) scores and the Urogenital Distress Inventory (UDI-6) scores. In addition, a qualitative description approach, using one-to-one interviews at the end of the intervention period was used to determine the principle factors related to the acceptability and feasibility of the intervention.
Results:
A total 23 (n=23) women with a mean age of 32.2 years were randomized to intervention group (n=13) or control group (n=10). Both groups improved on all measures, the only measure demonstrating a statically significant change was the UDI-6 score. Although most participants (72.7%) indicated value in the concept of the mHealth solution, technical difficulties (72.7%), a cumbersome process to set the intervention up (63.6%) and lack of comfort of the device itself (63.6%) were all key reasons that impeded the interventions acceptability. The majority of participants (72.2%) indicated that the assessment they received at the onset of the study was more useful than the mHealth solution and the perceived value of this initial assessment was echoed by all of the participants in the control group.
Conclusions:
Our pilot clinical study has demonstrated that the mHealth solution enabled to support pelvic floor muscle training was safe and a highly acceptable concept. However, a number of usability issues in both hardware and software hindered its feasibility as a health care intervention and acceptance by the participants. The mHealth solution studied superior to the standard care protocol for post-partum women in this study. Our findings can inform the redesign of mHealth solutions that may be of value if acceptability and feasibility issues can be overcome. Clinical Trial: N/A
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