International urogynecology journal · 2026
Facilitators and Barriers to Pelvic Floor Muscle Exercise Among Patients with Pelvic Floor Dysfunction: A Meta-Synthesis.
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Li Miao, Yang Xue, Liu Hangcheng, Wang Huan, Wang Haiyan, Li Xixi
Аннотация
INTRODUCTION AND HYPOTHESIS: Pelvic floor muscle training (PFMT) is a first-line conservative therapy for Pelvic Floor Dysfunction (PFD), yet its effectiveness is often compromised by poor long-term adherence. From the patient's viewpoint, this study explores the facilitators and barriers to exercise compliance, seeking to guide the formulation of scientific and rational PFMT protocols.
METHODS: The literature search covered the period from database inception to May 20, 2025, and was performed across nine databases, including PubMed, Web of Science, Embase, CINAHL, the Cochrane Library, CNKI, Wanfang Database, VIP Database, and CBM. The methodological quality of the included studies was assessed with the Joanna Briggs Institute (JBI) checklist for qualitative research, and a thematic synthesis was conducted.
RESULTS: A total of 13 studies were included, yielding 66 research findings, which were categorized into 11 categories and consolidated into two outcomes. The promoting factors of PFMT in patients with PFD (perceived benefits of exercise, strong social support, flexible and diverse training strategies, awareness of the threat of the disease, and self-efficacy promoting internal drive) and hindering factors of PFMT in patients with PFD (doubts about exercise value, insufficient access to information, low exercise self-efficacy, lack of exercise conditions and enjoyment, weak social support systems, and the impact of the disease and low symptom perception).
CONCLUSIONS: PFMT for women with PFD is influenced by multiple factors. Clinicians should address barriers, strengthen promoting factors, and actively optimize intervention strategies to provide patients with diverse, individualized pelvic floor muscle exercise (PFME) programs.
METHODS: The literature search covered the period from database inception to May 20, 2025, and was performed across nine databases, including PubMed, Web of Science, Embase, CINAHL, the Cochrane Library, CNKI, Wanfang Database, VIP Database, and CBM. The methodological quality of the included studies was assessed with the Joanna Briggs Institute (JBI) checklist for qualitative research, and a thematic synthesis was conducted.
RESULTS: A total of 13 studies were included, yielding 66 research findings, which were categorized into 11 categories and consolidated into two outcomes. The promoting factors of PFMT in patients with PFD (perceived benefits of exercise, strong social support, flexible and diverse training strategies, awareness of the threat of the disease, and self-efficacy promoting internal drive) and hindering factors of PFMT in patients with PFD (doubts about exercise value, insufficient access to information, low exercise self-efficacy, lack of exercise conditions and enjoyment, weak social support systems, and the impact of the disease and low symptom perception).
CONCLUSIONS: PFMT for women with PFD is influenced by multiple factors. Clinicians should address barriers, strengthen promoting factors, and actively optimize intervention strategies to provide patients with diverse, individualized pelvic floor muscle exercise (PFME) programs.