Novel Telerehabilitation Interventions for Stress Urinary Incontinence : A Systematic Review of Randomised Controlled Trials.

Abstract

To evaluate the effectiveness of telerehabilitation-delivered pelvic floor muscle training (PFMT) for women with stress urinary incontinence (SUI), focusing on clinical outcomes, adherence, satisfaction, and healthcare accessibility. A systematic search was conducted across four electronic databases: Embase, Scopus, CINAHL, and MEDLINE, in June 2024 and updated in May 2026. Eligible studies were randomised controlled trials (RCTs) examining PFMT delivered via virtual platforms (e.g., mobile applications, video conferencing, or internet-based programs) for women (≥18 years) with SUI. A total of 13 RCTs met all inclusion criteria. Two independent reviewers extracted data regarding study characteristics, clinical outcomes, and implementation metrics (adherence and satisfaction). Methodological quality was assessed using the Cochrane Risk of Bias 2 (RoB 2) tool. Due to substantial methodological and clinical heterogeneity, findings were synthesized narratively using the Synthesis Without Meta-analysis (SWiM) reporting guidelines. Digital interventions consistently produced significant subjective reductions in SUI symptoms and improvements in condition-specific quality of life (QoL). Telerehabilitation often demonstrated superior clinical outcomes and higher adherence compared to passive management or no-treatment controls. When compared to active conventional care, such as face-to-face physiotherapy or paper booklets, digital tools generally showed comparable rather than superior efficacy. Adherence was a primary mechanism for success, though technological complexity was a barrier in some protocols. Interventions were safe, with no serious adverse events reported. Telerehabilitation-delivered PFMT has potential as a safe, feasible, and effective modality for managing SUI. It offers a robust, scalable alternative to traditional care, particularly by improving accessibility for women facing geographical or logistical barriers.