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Is Hyacinth Exercise Better Than Conventional Pelvic Floor Exercise For Women Aged Above 55 Years With Urinary Incontinence?


Objective: To determine whether Hyacinth exercise is more effective than conventional pelvic floor exercise (PFE) alone for the treatment of urinary incontinence (UI) among women aged above 55 years. Hyacinth exercises are a combination of PFE exercise and Salat steps, of which the latter mirrors Muslim prayer positions.


Methods: This prospective, randomized, two-arm trial was performed at the University of Malaya Medical Center, Malaysia after ethics approval was obtained. 180 participants who fulfilled the inclusion criteria were randomised to either PFE or Hyacinth exercises.


Each participant was taught and prescribed exercises by a physiotherapist. The primary outcome was the severity of urinary incontinence (UI) evaluated via the Australian Pelvic Floor Questionnaire (APFQ) while the secondary outcome was assessed by measuring pelvic floor strength with the use of an intravaginal biofeedback device called Femiscan . Both assesments were obtained at recruitment, 2 and 6 months after enrolment.


 Results: An interim analysis was done based on data collected from 119 participants.


The mean score(Q) of improvement was higher in the Hyacinth group (3.89 ± 5.8) when compared to the PFE group (2.27±  4.5) at the first and second visit. When comparing Q improvement at first and third visit , again there was more improvement in the Hyacinth group (6.31 ±  5.06) compared to the PFE group (4.98 ±  4.1).The improvement of pelvic floor strength was higher in the Hyacinth group (21.2 ±  130) when compared to the PFE group (10.5 ±  67.3) at the first and second visit as well as first and third visit , Hyacinth group (38 ±  232) and PFE group (31.4 ±  137). There was no statistical difference in both improvement in Q or pelvic floor strengths in both groups.


Conclusion: Overall, there was no statistical difference in Q scores and pelvic floor strength measurements in both groups. However , the Hyacinth group showed better improvement during each visit and an reduction in SUI symptoms at 6 months when compared to PFE group. Although there has been no statistical difference between both groups at this interim analysis , we are confident that the ongoing recruitment and analysis will further improve the power and outcome of this clinical research.