Telerehabilitation interventions to manage postpartum urinary incontinence: scoping review

Soraia Braga; Salomé Ferreira; Tânia Manuel; Maria João Guerra; Armando Almeida; Paulo Alves

doi:10.33194/rper.2026.44180

Authors

Soraia Braga Faculdade de Ciências da Saúde e Enfermagem. Universidade Católica Portuguesa, Porto, Portugal https://orcid.org/0000-0002-6153-7931
Salomé Ferreira Escola Superior de Saúde, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal https://orcid.org/0000-0003-1685-9891
Tânia Manuel Faculdade de Ciências da Saúde e Enfermagem. Universidade Católica Portuguesa, Porto, Portugal https://orcid.org/0000-0003-0915-9950
Maria João Guerra Escola Superior de Enfermagem do Porto, Porto, Portugal https://orcid.org/0000-0002-2510-5955
Armando Almeida Faculdade de Ciências da Saúde e Enfermagem. Universidade Católica Portuguesa, Porto, Portugal https://orcid.org/0000-0002-5329-0625
Paulo Alves Faculdade de Ciências da Saúde e Enfermagem. Universidade Católica Portuguesa, Porto, Portugal https://orcid.org/0000-0002-6348-3316

DOI:

https://doi.org/10.33194/rper.2026.44180

Keywords:

Telerehabilitation, Urinary Incontinence, Pelvic Floor Muscle Training, Postpartum Period

Abstract

Introduction: Urinary incontinence is a common condition in the postpartum period, with a significant impact on quality of life. Pelvic floor muscle training (PFMT) is the first-line treatment; however, adherence to conventional interventions is often limited. Telerehabilitation has emerged as a promising strategy to improve access to and adherence to PFMT through digital technologies. Despite growing evidence of its effectiveness, gaps remain regarding the standardization of interventions for postpartum women.

Objective: This scoping review aims to map and analyze telerehabilitation interventions for PFMT in the management of postpartum urinary incontinence (UI).

Methods: A scoping review was conducted following the Joanna Briggs Institute framework for scoping reviews. A comprehensive search was performed across multiple databases, including Medline Complete, CINAHL Complete, PubMed, Cochrane, Scopus, Web of Science, and BASE, as well as relevant professional associations such as ICS, FIGO, EAU, SPG, APNUG, FSPOG, and APU. No time restrictions were applied. Studies involving postpartum adults in a home setting, focusing on telerehabilitation interventions for urinary incontinence management, available in open access and full text, and with different study designs were considered for inclusion.

Results: Seven studies were included in this review, identifying seven different telerehabilitation approaches for PFMT aimed at managing postpartum UI. These interventions primarily utilized mobile applications, biofeedback devices, and remote monitoring tools to enhance adherence, provide education, and improve pelvic floor muscle strength.

Conclusion: This review highlights the efficacy and feasibility of telerehabilitation interventions in postpartum UI management, supported by high-quality evidence from randomized controlled trials. Telerehabilitation enhances adherence to PFMT, provides interactive educational resources, and offers cost-effective, accessible solutions for postpartum care. Future research should focus on the long-term effects of these interventions, the integration of emerging technologies such as artificial intelligence, and cultural adaptability to ensure widespread accessibility and effectiveness. As digital health continues to evolve, telerehabilitation is expected to become a fundamental component of postpartum rehabilitation, offering innovative and scalable solutions for UI management.

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References

1. D’Ancona CAL, Nunes RLV, Antunes AA, Fraga R de, Mosconi A, Abranches-Monteiro L, et al. Tradução para a língua portuguesa do artigo original em inglês “ The International Continence Society (ICS) report on the terminology for adult male lower urinary tract and pelvic floor symptoms and dysfunction.” Einstein (São Paulo). 2021;19:1–44.

2. Cardozo L, Rovner E, Wagg A, Wein A. INCONTINENCE 7 th Edition 2023 7 th International Consultation on Incontinence ICUD EDITORS [Internet]. 2023. Available from: www.icud.info

3. Sociedade Portuguesa de Uroginecologia. Consenso Nacional sobre Uroginecologia 2021. Secção Portuguesa de Uroginecologia [Internet]. 2021;1–331. Available from: https://spginecologia.pt/consenso/11324/

4. Wang Y, Li H, Wang J, Hao Q, Tu Y, Chen Y, et al. A network meta-analysis protocol of conservative interventions for urinary incontinence in postpartum women. Vol. 99, Medicine (United States). Lippincott Williams and Wilkins; 2020. p. E21772.

5. Ribeiro GL, Firmiano MLV, Vasconcelos CTM, Neto JAV, Lopes MHB de M, Damasceno AK de C. CONHECIMENTO, ATITUDE E PRÁTICA DE GESTANTES SOBRE INCONTINÊNCIA URINÁRIA: ESTUDO OBSERVACIONAL. ESTIMA, Brazilian Journal of Enterostomal Therapy. 2023 Apr 18;

6. Ribeiro O, Néné M, Sequeira C. Enfermagem de Reabilitação: Conceções e Práticas. 1a. Lisboa: Lidel; 2021.

7. Gan ZS, Newman DK, Smith AL. Cross-sectional survey assessment of physical activity level and frequency of performing pelvic floor muscle exercises. Continence. 2023 Sep 1;7.

8. Bernard S, Boucher S, McLean L, Moffet H. Mobile technologies for the conservative self-management of urinary incontinence: a systematic scoping review. Vol. 31, International Urogynecology Journal. Springer; 2020. p. 1163–74.

9. Tedesco J. Remote Rehabilitation: A solution to Overloaded & Scarce Health Care Systems. Vol. 1, Trends in Telemedicine & E-health. 2018.

10. Wang X, Xu X, Luo J, Chen Z, Feng S. Effect of app-based audio guidance pelvic floor muscle training on treatment of stress urinary incontinence in primiparas: A randomized controlled trial. Int J Nurs Stud. 2020 Apr 1;104.

11. Papanikolaou DT, Lampropoulou S, Giannitsas K, Skoura A, Fousekis K, Billis E. Pelvic floor muscle training: Novel versus traditional remote rehabilitation methods. A systematic review and meta-analysis on their effectiveness for women with urinary incontinence. Vol. 42, Neurourology and Urodynamics. John Wiley and Sons Inc; 2023. p. 856–74.

12. Peters MDJ, Godfrey C, McInerney P, Munn Z, Tricco AC, Khalil H. Chapter 11: Scoping reviews. In: Aromataris E, Munn Z, editors. JBI Manual for Evidence Synthesis [Internet]. Adelaide, Australia: JBI; 2020. Available from: https://jbi-global-wiki.refined.site/space/MANUAL/355863557/Previous+versions?attachment=/download/attachments/355863557/JBI_Reviewers_Manual_2020June.pdf&type=application/pdf&filename=JBI_Reviewers_Manual_2020June.pdf#page=406

13. Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Ann Intern Med. 2018 Oct 2;169(7):467–73.

14. Löjdahl E, Lindam A, Asklund I. App-based pelvic floor muscle training in pregnant and postnatal women: A prospective cohort study exploring factors associated with prevention and improvement of urinary incontinence. Health Sci Rep. 2022 Sep 1;5(5).

15. Artymuk NV, Khapacheva SY. Device-assisted pelvic floor muscle postpartum exercise programme for the management of pelvic floor dysfunction after delivery. Journal of Maternal-Fetal and Neonatal Medicine. 2022;35(3):481–5.

16. Wang J, An D. Effect of Internet combined with pelvic floor muscle training on postpartum urinary incontinence. Int Urogynecol J. 2023 Oct 1;34(10):2539–46.

17. Dufour S, Fedorkow D, Kun J, Deng SX, Fang Q. Exploring the impact of a mobile health solution for postpartum pelvic floor muscle training: Pilot randomized controlled feasibility study. JMIR Mhealth Uhealth. 2019 Jul 1;7(7).

18. Chu L, Jin X, Wu S, Tong X, Li H, Chen X. Effect of Pelvic Floor Muscle Training With Smartphone Reminders on Women in the Postpartum Period: A Randomized Controlled Trial. Urogynecology. 2023 Feb 1;30(2):138–46.

19. Kinouchi K, Ohashi K. Smartphone-based reminder system to promote pelvic floor muscle training for the management of postnatal urinary incontinence: Historical control study with propensity score-matched analysis. PeerJ. 2018;2018(2).

20. Blanco Gutiérrez V, Hundley VA, Way S. The Experience of Women From Underrepresented Groups With Urinary Incontinence: A Systematic Review. Vol. 34, Journal of Transcultural Nursing. SAGE Publications Inc.; 2023. p. 288–300.

21. Miranda DB, Marostica FC, Matão MEL. Influência do fator cultural no processo de cuidado puerperal. Revista Eletronica Gestão & Saúde. 2015 Apr 29;6(3):2444.

22. Hawkins SS. Telehealth in the Prenatal and Postpartum Periods. Vol. 52, JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing. Elsevier B.V.; 2023. p. 264–75.

23. Wang X, Xu X, Luo J, Chen Z, Feng S. Effect of app-based audio guidance pelvic floor muscle training on treatment of stress urinary incontinence in primiparas: A randomized controlled trial. Int J Nurs Stud. 2020 Apr 1;104.

24. Zhang JJ, Van de Winckel A. Editorial: Insights in interventions for rehabilitation: 2023. Vol. 4, Frontiers in Rehabilitation Sciences. Frontiers Media SA; 2023.

25. Gajarawala SN, Pelkowski JN. Telehealth Benefits and Barriers. Journal for Nurse Practitioners. 2021 Feb 1;17(2):218–21.

26. Houser SH, Flite CA, Foster SL. Privacy and Security Risk Factors Related to Telehealth Services-A Systematic Review. 2023.

27. Al Baalharith I, Al Sherim M, Almutairi SHG, Albaqami ASA. Telehealth and Transformation of Nursing Care in Saudi Arabia: A Systematic Review. Vol. 2022, International Journal of Telemedicine and Applications. Hindawi Limited; 2022.