Telerehabilitation helps stress incontinence Telerehabilitation-delivered pelvic floor muscle training appears safe and effective, mainly matching active conventional care.
*Systematic review of randomized trials; Level 1a.

Citation

Martin N, Venkataramadas K, Singh A, et al. Novel Telerehabilitation Interventions for Stress Urinary Incontinence: A Systematic Review of Randomised Controlled Trials. Archives of Physical Medicine and Rehabilitation. 2026. doi:10.1016/j.apmr.2026.08.020

Background

Stress urinary incontinence is common and can reduce quality of life. Pelvic floor muscle training is first-line treatment, but access, embarrassment, cost, and travel can limit care.

Patients

Women aged 18 years or older with stress urinary incontinence. Studies were excluded when symptoms were due to chronic neurologic disease, cancer, Parkinson disease, or acute postoperative problems.

Intervention

Pelvic floor muscle training delivered remotely through apps, internet programs, telephone, video visits, or digital devices.

Control

No treatment, lifestyle advice, written instructions, booklets, postal programs, standard home exercises, or in-person therapy.

Outcome

Urinary leakage symptoms, quality of life, adherence, satisfaction, and adverse events.

Follow-up Period

Varied across trials; longest follow-up was 2 years.

Results

Thirteen randomized trials including about 1,067 women were reviewed. Because studies differed substantially, results were summarized narratively rather than pooled.
Comparison Significant finding
Digital training versus no treatment or lifestyle advice Improved urinary symptoms, quality of life, adherence, and satisfaction
Apps versus written or standard instructions Often improved adherence; some trials showed better quality of life
Digital training versus active conventional care Usually similar, not clearly superior
Internet training plus Pilates versus self-guided Kegel training Greater leakage reduction
Booklet versus one mobile app Booklet had better symptom reduction and adherence

Several studies used per-protocol or complete-case analyses. Active comparators were reasonable current conservative options. No serious adverse events were reported.

Limitations

No meta-analysis was possible because interventions, controls, outcomes, and follow-up differed widely. Many outcomes were self-reported and unblinded. Attrition was high in some trials, reaching 46.2%. The review was not prospectively registered, and only English full-text articles were included.

Funding

No specific funding; authors reported no conflicts.

Clinical Application

Offer validated telerehabilitation pelvic floor training when access to in-person therapy is limited; do not assume it outperforms good active care.