Effectiveness of pelvic floor muscle exercises intervention in improving knowledge, attitude, practice and confidence among pregnant women in Malaysia.

The intervention group received the newly developed pelvic floor muscles exercise (PFME) intervention which developed based on Health Belief Model and Motivational Interviewing in addition to the usual prenatal care. The PFME intervention consisted of single PFME education sessions delivered at baseline, a personalized short text message reminder and three booster sessions at the week 4 post-education session, early third-trimester and late third-trimester. The whole intervention was facilitated by a primary researcher who was a physiotherapist. The first PFME education session was provided in a group of approximately 4 to 8 persons for about 40 to 45 minutes. During the session, the primary researcher actively engaged in facilitating discussion and providing information on urinary incontinence and PFME based on the perceived susceptibility and severity of UI, perceived benefit of PFME and perceived barriers to adhering to PFME. This session also involved teaching, demonstrating and practicing correct pelvic floor muscle contraction, together with educating on integrating the exercise into daily activities and healthy bladder habit strategies during and following pregnancy. This was followed by a weekly personalized short message reminder on adherence to PFME for eight week, examples “Remember your target PFME, 8-12 repetitions hold for 6-8 second three time daily" and "Don’t’ give up doing your PFME". The booster sessions took approximately 30 minutes which specifically focused on reinforcing the skills and aims for targeted PFME, discussing experiences, challenges and barriers in practicing PFME and to facilitate the continuous practice of PFME. The PFME is involves “squeeze with inward and upward lift” movement around urethra, vagina and anus. This exercise targeting to increase the strength, endurance and to improve function of pelvic floor muscles specifically in prevention and treatment of urinary incontinence. The targeted pelvic floor muscles exercise prescription were 8-12 repetitions hold for 6-8 second three time daily” and integrated the exercises into daily activities.