It is almost ten years since the launch of an evidence-based, peer-reviewed, pelvic floor muscle exercise app for women, created by a pelvic health physiotherapist and a digital technology company. It was launched at a time when such technologies were just becoming popular in the healthcare space. The popularity of the initial app led to further developments, including an equivalent app for men, an integrated bladder diary and a connected clinician platform.

It was decided to undertake a data analysis to review the uptake, popularity and use of the consumer apps at the time of the abstract submission.

A retrospective review of the data was performed. The fully anonymised data is accessible via Flurry Analytics, and was retrieved by the data analyst at the technology company that developed the apps. All appropriate GDPR policies were in place and followed.

Statistics for the consumer versions of the pelvic floor muscle exercise apps since launch (September 2013) include:

Number of downloads - 527,825
Number of saved exercise sessions - 49, 491, 330
Registered users who do their exercises once a day - 43.6%
Registered users who do their exercises twice a day - 38%
Registered users who do their exercises three times a day - 13%
In a typical week, the average user spends 18 minutes in the app
In a typical year, the average user spends four hours in the app

At the time of writing this sentence, there were 5,163 people performing their pelvic floor exercises!

Tracking data on a digital intervention allows us to extract objective data that has not been accessible previously. The app is very popular and is being used repeatedly by users to guide and record their pelvic floor muscle exercise programme.

Women are usually advised to perform their pelvic floor exercises three times a day (and up to six times a day if they have pelvic floor symptoms). Men are usually asked to perform their exercises three times a day, but only if they have pelvic floor symptoms. It has been recognised for many years that most people do not manage this level of activity and these statistics allow us to understand adherence and monitor any improvements or otherwise.

It is also possible to monitor the direct impact of marketing, media reporting and social media influencers as these events can be seen to cause spikes in downloads of the apps (see figure 1).

Pelvic floor muscle exercises are an evidence-based method of supporting and improving pelvic health, but it is recognised that adherence to the exercises is often a challenge. Women are recommended to exercise their pelvic floor muscles three times a day and are usually advised to do them on a daily basis (1). 

It is also recognised that anyone being asked to perform pelvic floor muscle exercises needs clear exercise guidelines, and behavioural support. It has  been shown that having a regular cue to exercise prompts adherence to pelvic floor muscle training (2) and the app discussed above is designed to do all the above.

The total of almost 50 million saved exercise sessions is a clear indication of the effectiveness of digital interventions, such as an app. It is being used repeatedly to support adherence to pelvic floor muscle exercises. The number of downloads is increasing each year and reflects the increasing awareness of the interest in performing pelvic floor muscle exercises.

www.rcog.org.uk/for-the-public/perineal-tears
Factor's affecting women's adherence t0 pelvic floor muscle exercises in a first pregnancy: a qualitative interview study. H Cooper and C Carus, Autumn 2015, 117, 29-34. Journal of Pelvic, Obstetric and Gynaecological Physiotherapy