{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T01:34:53Z","timestamp":1771637693779,"version":"3.50.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T00:00:00Z","timestamp":1707436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Glob. Womens Health"],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Urinary incontinence (UI) is highly prevalent in low- and middle-income countries (LMIC). Concurrently, the availability of surgical or conservative UI treatments in LMIC is limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We conducted a prospective feasibility study of Belize women with UI treated with pelvic floor physical therapy (PFPT) and education (PFE). Patients received individual PFPT\/PFE over 2 days, consisting of biofeedback-enhanced PFMT in addition to behavioral, dietary, and general pelvic education. Patient completed a daily 6-month home regimen including 7 PFMT exercises (total 70 repetitions) comprising both endurance and quick flick exercises. Patients also performed comprehensive dietary and behavioral modification activities. Outcomes were assessed at baseline and 6-months, including validated symptom (ICIQ-FLUTS) and QOL (IIQ-7) questionnaires, and strength testing (PERFECT score, perineometry).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twenty-eight patients underwent baseline assessment. Four patients were lost to in-person 6-month follow-up, with two of these patients completing subjective assessment only by telephone. The mean (\u00b1SD) patient age, BMI, and parity were 50.0 (\u00b110.0) years, 33.2 (\u00b15.8), and 2.8 (\u00b11.5). Provider assessment demonstrated patient comprehension of basic, endurance, and quick flick pelvic floor contractions in 28 (100%), 24 (86%), and 24 (86%) patients, respectively. At 6-month follow-up, significant improvements were seen across multiple validated questionnaire and strength measurement assessments. Median patient-reported improvement level was 7.0 on a 10-point Likert scale.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Study patients demonstrated good understanding of PFMT\/PFE and program completion was associated with significant improvements across a variety of subjective incontinence and quality of life outcomes, as well as objective strength testing.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fgwh.2024.1325259","type":"journal-article","created":{"date-parts":[[2024,2,9]],"date-time":"2024-02-09T05:01:50Z","timestamp":1707454910000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Pelvic floor therapy program for the treatment of female urinary incontinence in Belize: a pilot study"],"prefix":"10.3389","volume":"5","author":[{"given":"David E.","family":"Rapp","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacqueline","family":"Zillioux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fionna","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marieke","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"Little","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeanice","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,2,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e9","DOI":"10.1002\/bjs.9329","article-title":"Global disease burden of conditions requiring emergency surgery","volume":"101","author":"Stewart","year":"2014","journal-title":"J Br Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S8","DOI":"10.1016\/S2214-109X(14)70384-5","article-title":"Global burden of surgical disease: an estimation from the provider perspective","volume":"3","author":"Shrime","year":"2015","journal-title":"Lancet Glob Health"},{"key":"B3","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1016\/S0140-6736(15)60160-X","article-title":"Global surgery 2030: evidence and solutions for achieving health, welfare, and economic development","volume":"386","author":"Meara","year":"2015","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1007\/s00192-010-1215-0","article-title":"Pelvic organ prolapse and incontinence in developing countries: review of prevalence and risk factors","volume":"22","author":"Walker","year":"2011","journal-title":"Int Urogynecol J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1007\/s00192-019-03992-z","article-title":"Prevalence of symptomatic pelvic floor disorders in community-dwelling women in low and middle-income countries: a systematic review and meta-analysis","volume":"30","author":"Islam","year":"2019","journal-title":"Int Urogynecol J"},{"key":"B6","first-page":"1","volume-title":"Disease Control Priorities in Developing Countries","author":"Jamison","year":"2006"},{"key":"B7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1596\/978-1-4648-0346-8","volume-title":"Disease Control Priorities, (Volume 1): Essential Surgery","author":"Debas","year":"2015"},{"key":"B8","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1097\/UPJ.0000000000000342","article-title":"Financial impact of urologic conditions in men and women in Belize","volume":"9","author":"Yeaman","year":"2022","journal-title":"Urol Pract"},{"key":"B9","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.juro.2017.06.061","article-title":"Surgical treatment of female stress urinary incontinence: AUA\/SUFU guideline","volume":"198","author":"Kobashi","year":"2017","journal-title":"J Urol"},{"key":"B10","doi-asserted-by":"publisher","first-page":"558","DOI":"10.1097\/JU.0000000000000309","article-title":"Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: aUA\/SUFU guideline amendment 2019","volume":"202","author":"Lightner","year":"2019","journal-title":"J Urol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1016\/j.gyobfe.2015.03.026","article-title":"Pelvic floor muscle training and pelvic floor disorders in women. 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