Pilot Study

Pre-Rehabilitation of the Pelvic Floor Before
Radiation Therapy for Cervical Cancer: A Pilot

Study
PICO Validity Importance Applicable
Analysis
P I
Women (18–70 years old) PFMEs

with cervical cancer
C O
Baseline data with data after radiotherapy PF strength, PFM activation, the
combined with home-based PFMEs. presence of UI symptoms, and
adherence to the PFME regimen
PICO Analysis
Validit Importance Applicable
y
Because the authors had

Did the trial address a clearly determined:
focused issue?
1. Population
2. Intervention
YES 3. Comparison
4. Outcome
PICO Analysis
y
Was the assignment of patients to

NO
treatments randomized?
Because this quasi-

experimental study had no
control group.
PICO Analysis
y
Historia
Because:
Were all of the patients who  15 patients were declined to participate and 21
entered the trial properly patients were lost to follow-up because they didn’t
complete radiotherapy (n=2)
accounted for at its
conclusion?  didn’t return to follow-up control (n = 19)
 had very bad health conditions; hospitalized (n = 1).
Nevertheless, there was no significant difference (p <

NO 0.05) between women lost to follow-up and women
who finished the study.
PICO Analysis
y
Were patients, health

workers, and study
personnel ‘blind’ to Because this quasi-experimental study had no control
treatment? group. This blinding method is not important because
this study compares baseline data to the data after
radiotherapy combined with home-based PFMEs.
NO
PICO Analysis
y
Because this quasi-experimental study had no control group.

Comparison between subjects shows there was heterogeneity
regarding their education levels.
Were the groups similar at

the start of the trial?
NO
PICO Analysis
y
Aside from the experimental intervention, were the

groups treated equally?
YES
All subjects were treated

equally.
PICO Analysis Validity Importance Applicable
How large was the

treatment effect?
Historia
 There was no significant change in PFM strength and activation from baseline to approximately 1 month
after radiation.
 The median of PFM strength was 2 at baseline and 1 month after radiation therapy, which means the
presence of a weak but sustained contraction.
 The median ICIQ-SF score, representing the impact of incontinence on daily life, was low both at baseline
(four points) and 1 month after RT (three points). There was no ICIQ-SF score difference between baseline
and after RT (p=0,794).
Historia Cont.
 The frequency and amount of UI slightly reduced from baseline to post-radiation therapy.
 Symptoms of gas incontinence were reported by 75.0% of the participants at baseline and by only 28.6%
after the intervention.
 Symptoms of FI were reported by 39.3% of the participants at baseline and by 25.0% after the intervention.
 Only the mean EMG measurement 1 month after radiation therapy was different in these groups (women
with and without UI), with higher scores for women without UI than for women with UI symptoms (median
7 and 5 respectively, p = 0.022).
 PFM strength was similar in these groups (p < 0.05) (women with and without UI)
Historia
Because:
How precise was the estimate of 1.
This study had no control
group
the treatment effect?
The authors didn’t measure
2. the 95% confidence interval
CAN’T We can’t measure the 95%
TELL 3. confidence interval because
this study had continuous data
Historia
Can the results be applied in your Because :

context? (or to the local
May not be representative
population?) 1. of the world population
Different
NO 2.
sociodemographic and
cancer-related clinical
characteristics to ours
Were all clinically important outcomes

considered?
YES
Because the authors had considered the benefit of pelvic floor

muscle exercises to the PF strength, PFM activation, the
presence of UI symptoms, and adherence to the PFME
regimen.
Are the benefits worth Because this study suggests that pre-rehabilitation
the harms and costs? teaching PFMEs might be a protective factor for
preserving PFM strength and preventing
incontinence 1 month after radiation therapy.
Nevertheless, we need more analysis to know the

YES reason for low adherence to this exercise.
THANK YOU

Pilot Study

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Pilot Study

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Pre-Rehabilitation of the Pelvic Floor Before

Radiation Therapy for Cervical Cancer: A Pilot

Women (18–70 years old) PFMEs

Because the authors had

Was the assignment of patients to

Because this quasi-

 had very bad health conditions; hospitalized (n = 1).

Nevertheless, there was no significant difference (p <

Were patients, health

Because this quasi-experimental study had no control group.

Were the groups similar at

Aside from the experimental intervention, were the

All subjects were treated

How large was the

Can the results be applied in your Because :

Were all clinically important outcomes

Because the authors had considered the benefit of pelvic floor

Nevertheless, we need more analysis to know the

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