骨盆底肌肉訓練(PFMT, Pelvic floor muscle training)對於應力型尿失禁的病人能夠改善其症狀，而對於急迫型尿失禁與混和型尿失禁也能有所幫助。而本篇想探討的是PFMT到底獨練練比較好?還是眾練練比較好?抑或是先獨練練後加入眾練練比較好。這個研究從網路與報章雜誌廣告招募了年齡大於18歲患有應力型尿失禁的女病人，經過篩選，隨機分成三組，每組30人，每一組都有物理治療師來教導如何做如何PFMT，其中分成三組為個人訓練(individual training)，個人訓練後轉為團體IPGT(individual sessions progressing to group training)組，以及團體訓練組(Group training)，其中IT與IPGT組在個人訓練時會有物理治療師進行陰道觸診來確認是否訓練方式正確，三組訓練時機皆為12周，一周一次。

訓練之後比較立即的效果、3個月的效果跟6個月後維持的效果。在這三組訓練完之後，從主觀上問卷(King's HealthQuestionnaire (KHQ))比較，我們可以看到PFMT這三組跟訓練前都可以發現明顯尿失禁的改善，3個月跟6個月後的問卷，依然可以看到病人症狀改善可以維持，但是三組之間的主觀改善幅度並沒有明顯差異。

而在客觀的骨盆底壓力測量儀跟骨盆底收縮力道的方面，獨練練後眾練練(IPGT)組的改善幅度則比其他兩組高。但是在這三組都發現到，隨著時間的增加，病人對於自己進行PFMT的效率與信心也會逐漸下滑，而病人的排尿日誌與骨盆底運動的持續率也不高，而本篇給出的解釋可能是本篇受訪的女性社經地位與教育程度較低有關。

這篇研究告訴我們有專屬的教練很好，可以藉由觸診立即回饋告訴病人是否進行正確的骨盆底訓練，如果沒有教練，團體內互相激勵的效果也很好，但訓練結束之後，對於自己訓練的成效與維持就會隨著時間逐漸下降。這也呼應到我們人所有學習的部分，如果有專屬教練與同儕的激勵，能夠有客觀的進步量尺跟互相切磋，學習新東西就會進步很快，如果逐漸推離這個訓練部分，最後能維持下去的人就會越來越少。對於尿失禁病人，或許開設長期的訓練班或是團體也是未來醫療人員可以思考的一個方向。

Aims: To assess the effects of individual pelvic floor muscle (PFM) training vs individual training (IT) progressing to group training (GT) vs group‐only training in women with stress urinary incontinence (SUI).

Methods: Randomized controlled and pragmatic clinical trials with 90 women with SUI. Participants were randomly allocated to one of three groups: IT, GT, or four individual sessions progressing to group training (IPGT). The inter- vention included 12 sessions, once a week, with direct supervision by a phy- sical therapist. Primary outcome: severity according to the King's Health Questionnaire. Secondary outcomes: PFM function by palpation and man- ometer, bladder and exercise diaries, PFM training adherence, and self‐ efficacy. Reassessments were conducted at the end of the intervention, 3 and 6 months after the intervention. Intra‐ and intergroup analysis for all outcomes was performed using a multivariate analysis of variance. In the mixed‐effects model used, the evaluation groups and times and their interactions were considered. A significance level of 5% was adopted.

Results: After the intervention, the severity measure improved in all three groups (P < .001), without difference between them (P = .56). The benefits of the intervention were maintained 3 and 6 months after the end of the supervised training (P < .001). The IPGT group had a significant improvement in PFM function when compared to the other groups posttreatment (P < .001).

Conclusion: PFM training improved the severity of urinary incontinence in all groups after 12 sessions of training supervised by a physical therapist. IT progressing to GT improved the function of upper PFM when compared to the other groups.