Effect of the app Tät®

The Tät® app has been evaluated through several research studies at Umeå University. Women who leaked urine upon exertion and who performed exercises for three months with the help of the app, experienced reduced leakage and increased quality of life, compared with a group that did not use Tät®. These improvements were maintained when the women were followed up after two years. One study also showed that improvements were greater the more frequently the women used the app and the more often they performed the exercises. The app treatment includes information about the pelvic floor, stress urinary incontinence and lifestyle habits that affect incontinence, as well as a programme for pelvic floor muscle training. Among pregnant women who used the app for preventive training, 7 out of 10 retained continence after three months.

Scientific articles and doctoral dissertations published as part of the Tät.nu project.

Scientific articles 

The results of this study showed that women who used the Tät® app for three months experienced improvements in terms of symptoms, quality of life and number of leakages, compared to a control group.

Mobile app for treatment of stress urinary incontinence: A randomized controlled trial.
Asklund I, Nyström E, Sjöström M, Umefjord G, Stenlund H, Samuelsson E.
Neurourol Urodyn. 2017 Jun;36(5):1369-1376. doi: 10.1002/nau.23116. Epub 2016 Sep 9.
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We analysed data from the study of the Tät® app to find out who improved the most after three months of self-management. This analysis showed that more of the women who had higher expectations of the treatment, stayed at the same weight, and experienced increased pelvic floor strength also experienced greater improvements.

Treatment of stress urinary incontinence with a mobile app: factors associated with success.
Nyström E, Asklund I, Sjöström M, Stenlund H, Samuelsson E.
Int Urogynecol J 2017 Dec 8. doi: 10.1007/s00192-017-3514-1. [Epub ahead of print]
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The Tät® app simplified self-management of incontinence. The app was well-liked as a motivational aid for a fairly challenging programme of pelvic floor training.

User experience of an app-based treatment for stress urinary incontinence: qualitative interview study. Asklund I, Samuelsson E, Hamberg K, Umefjord G, Sjöström M.J Med Internet Res 2019;21(3):e11296. doi:10.2196/11296. Link to summary  Link to article

After two years, we followed up the women who had used the Tät® app to treat stress urinary incontinence. Improvements in symptoms and quality of life compared with prior to the treatment were statistically valid and remained at the same level as after three months of treatment.

Self-management of stress urinary incontinence via a mobile app: 2–year follow-up of a randomized controlled trial. Hoffman V, Söderström L, Samuelsson E.
Acta Obstet Gynecol Scand. 2017 Jul 17. doi: 10.1111/aogs.13192. [Epub ahead of print]
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A health-economics analysis of the Tät® app showed that the app provides a new, cost-effective, first-line treatment option, which may increase access to healthcare for these women in an economically sustainable manner.

Mobile app for treatment of stress urinary incontinence: A cost-effectiveness analysis.
Sjöström M, Lindholm L, Samuelsson E. J Med Internet Res 2017; 19(5): e154. DOI: 10.2196/jmir.7383. Link to summary    Link to article

Results from more than 2,600 women with urinary leakage who answered the anonymous questionnaires when downloading the app and after three months. Improvements in incontinence symptoms are statistically valid and two thirds of the women state that they have experienced improvements. The extent of the improvements were the same regardless of the type of incontinence. Improvements were somewhat less than in the earlier study with a control group, and the users trained less often.

Real-world effectiveness of app-based treatment for urinary incontinence: a cohort study. Rygh P, Asklund I, Samuelsson E. BMJ Open 2021;11:e040819. doi: 10.1136/bmjopen-2020-040819. Link to summary  Link to article

When the Tät® app was freely available, two thirds of the users who answered the follow-up questionnaire experienced improvements. We analysed whether any factors predicted improvement. Regular pelvic floor training was shown to be important, as was regular use of the app.

Self-management of incontinence using a free mobile app: factors associated with improvement. Nyström, E., Söderström, L. & Samuelsson, E. Int Urogynecol J (2021). https://doi.org/10.1007/s00192-021-04755-5. Link to article 

In a cohort study of pregnant and postnatal women who used the app Tät®, 3680 women answered a questionnaire at download and after three months use. Among 1071 pregnant women who used the app for preventive training, 72% retained continence after three months. Among 982 postnatal women with incontinence, 73% experienced improvement after three months treatment with the app. Important factors for experiencing improvement were regular pelvic floor muscle training and app use.

App‐based pelvic floor muscle training in pregnant and postnatal women: a prospective cohort study exploring factors associated with prevention and improvement of urinary incontinence. Löjdahl E, Lindam A, Asklund I. Health Sci Rep2022;5:e781.doi:10.1002/hsr2.781. Link to article

Doctoral dissertations

Ina Asklund: A mobile app for self-management of urinary incontinence: treatment effect and user experience (2020). Link 

Emma Nyström: Self-management of urinary incontinence using eHealth: clinically relevant improvement, treatment effect and factors associated with success (2019). Link 

Systematic reviews that include the Tät app:

A systematic review of apps for pelvic floor muscle training for women, focused on the principles included in the apps that increase adherence to the training. Tät was one of eight apps assessed and the conclusion was that it used three different principles, that it increased adherence to the pelvic floor training and that it was cost-effective. 

Jaffar A, Tan CE, Mohd-Sidik S, Admodisastro N, Goodyear-Smith F. Persuasive Technology in an mHealth App Designed for Pelvic Floor Muscle Training Among Women: Systematic Review. JMIR Mhealth Uhealth 2022;10(3):e28751.

An evaluation of free apps for urinary incontinence and prolapse focused on how well the apps fulfilled different criteria for good quality in medical apps. Tät was one of 28 apps included and was assessed as being of good quality. Benefits highlighted by the evaluation were that the app contained information about incontinence and was developed by medical professionals.

Karsalia M, Malik R. Evaluation of free mobile health applications for pelvic organ prolapse and urinary incontinence. Am J Surg. 2022 Jan;223(1):187-193. doi: 10.1016/j.amjsurg.2021.07.046. Epub 2021 Aug 8. PMID: 34391568.

A systematic review of randomised controlled trials conducted between 2007 to 2020 to evaluate the effect of apps aimed at improving urinary incontinence. Four trials were included, two of which were related to the Tät app. All the trials were deemed to be of high quality and the results showed improved incontinence symptoms and increased adherence to the treatment. They recommend including the use of mobile apps for the treatment of urinary incontinence in current treatment guidelines.

Widdison R, Rashidi A, Whitehead L. Effectiveness of mobile apps to improve urinary incontinence: a systematic review of randomised controlled trials. BMC Nurs. 2022 Jan 28;21(1):32. doi: 10.1186/s12912-022-00812-6. PMID: 35090464; PMCID: PMC8796429.

A systematic review of apps for women with urinary incontinence and assessment against a validated scale for mobile apps. Tät was one of 20 apps included and it was the only one that was evidence-based and evaluated through a clinical trial. 

Ho L, Macnab A, Matsubara Y, Peterson K, Tsang B, Stothers L. Rating of pelvic floor muscle training mobile applications for treatment of urinary incontinence in women. Urology. 2020. https://doi.org/10.1016/j.urology.2020.08.040.

A systematic review of non-supervised treatment programmes for urinary problems in women. Ten studies were found that looked at treatment programmes for urinary incontinence, one of which was Tät. They found that non-supervised treatment programmes were effective for the treatment of urinary incontinence in women, and that their usage should be increased. 

Wu C, Newman DK, Palmer MH. Unsupervised behavioral and pelvic floor muscle training programs for storage lower urinary tract symptoms in women: a systematic review. Int Urogynecol J. 2020 Dec;31(12):2485-2497. doi: 10.1007/s00192-020-04498-9. Epub 2020 Sep 1. PMID: 32870339.

A systematic review of studies of the use of telemedicine within urology was carried out in 2020. It found that treating stress urinary incontinence with lifestyle advice and pelvic floor training can be carried out safely and effectively via telemedicine, and the Tät app was highlighted as an example. 

Novara G, Checcucci E, Crestani A, Abrate A, Esperto F, Pavan N, De Nunzio C, Galfano A, Giannarini G, Gregori A, Liguori G, Bartoletti R, Porpiglia F, Scarpa RM, Simonato A, Trombetta C, Tubaro A, Ficarra V; Research Urology Network (RUN). Telehealth in Urology: A Systematic Review of the Literature. How Much Can Telemedicine Be Useful During and After the COVID-19 Pandemic? Eur Urol. 2020 Dec;78(6):786-811. doi: 10.1016/j.eururo.2020.06.025. Epub 2020 Jun 18. PMID: 32616405; PMCID: PMC7301090.

A review and assessment of apps for pelvic floor training. Of the 32 apps identified, Tät was ranked high and was given as an example of one of the few apps that had been evaluated as part of a clinical trial and that showed good results and cost-effectiveness.

Barnes KL, Dunivan G, Jaramillo-Huff A, Krantz T, Thompson J, Jeppson P. Evaluation of Smartphone Pelvic Floor Exercise Applications Using Standardized Scoring System. Female Pelvic Med Reconstr Surg. 2019 Jul/Aug;25(4):328-335. doi: 10.1097/SPV.0000000000000563. PMID: 29489554.

A Cochrane review from 2018 looking at the effects of pelvic floor muscle training for urinary incontinence in women states that pelvic floor muscle training can cure or reduce symptoms of incontinence. Only one cost-effectiveness study was found and it was the one covering Tät. They concluded that the economic evaluation of the Tät app shows that app-based pelvic floor training may be a promising strategy for the treatment of urinary incontinence. 

Dumoulin C, Cacciari LP, Hay-Smith EJC. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2018 Oct 4;10(10):CD005654. doi: 10.1002/14651858.CD005654.pub4. PMID: 30288727; PMCID: PMC6516955.