Pelvic Floor Training Apps Are Often Low-Quality

By Lisa Rapaport

October 01, 2020

(Reuters Health) - Most mobile apps that offer pelvic floor training for treating urinary incontinence are of low quality and have not been evaluated in clinical trials, a recent study suggests.

Researchers used the Mobile App Rating Scale (MARS) tool to examine 20 English-language apps available in the Canadian Apple App Store and Google Play Store during the first half of January 2020. The 30-item MARS tool looks at the quality of the apps based on: information, functionality, engagement, aesthetics, subjective quality, and perceived impact.

To identify potential apps for inclusion in the analysis, researchers searched for apps using the terms "pelvic floor muscle therapy," "kegels," and "incontinence." They found seven apps only for Apple devices, six for only Google devices, and seven apps available for both Apple and Google.

While three apps were developed with input from a physician and three were created with input from a physiotherapist, the remaining apps didn't specify any developer credentials, the study team reports in Urology. And just one app had been evaluated in a clinical trial.

"Most apps are not developed based on evidence from research and clinical experience," said Dr. Eva Samuelsson, of the department of public health and clinical medicine at Umea University in Sweden.

"It is important that professionals with experience from treatment of urinary incontinence are involved in the development of apps," Dr. Samuelsson, who wasn't involved in the study, said by email.

Based on the MARS tool, the median overall app quality score was 3.7 on a 0.0-to-5.0 scale, the study found. The median MARS score for functionality was 4.0, while the median score for engagement was 3.6 and the median score for information was 3.4.

The MARS tool is an accepted method for evaluating apps but may not necessarily tell clinicians or patients which apps are associated with the best outcomes in terms of improving urinary incontinence, said Dr. Samuelsson, who worked on a project at Umea University to develop the "Tat" app for the treatment of urinary incontinence.

The senior author of the current study, Dr. Lynn Stothers of the University of British Columbia in Vancouver, Canada, didn't respond to requests for comment.

In their report, Dr. Stothers and colleagues note the lack of studies linking MARS scores to clinical outcomes as a limitation of the study.

Even so, said Dr. Peter Jeppson, Division Chief of Urogynecology at the University of New Mexico in Albuquerque, the results are valuable to clinicians because they may not have the time to download and test apps themselves and can't expect to get useful information just from perusing user ratings in the app stores.

"Because apps are developed directly for consumers it is important to periodically evaluate the available apps to provide guidance to patients and providers with objective evidence to guide selection and recommendation of the most medically accurate and appropriate apps," Dr. Jeppson, who wasn't involved in the study, said by email.

SOURCE: Urology, online September 2, 2020.