Add-On Effect of Postural Instructions to Abdominopelvic Exercise on Urinary Symptoms and Quality of Life in Climacteric Women with Stress Urinary Incontinence. A Pilot Randomized Controlled Trial.

Laura Fuentes-Aparicio,Mercè Balasch-Bernat,Laura López-Bueno

doi:10.3390/ijerph18030928

Abstract

The aim of this study was to investigate the add-on effect of postural instructions to an abdominopelvic exercise program on incontinence urinary symptoms (UI symptoms) and quality of life (QoL) in climacteric women with stress urinary incontinence (SUI). A randomized controlled trial was performed with a total of 40 climacteric women with SUI aged between 46 and 75 years old. Participants were randomly assigned to two groups: a group performing an abdominopelvic exercise program (AEP) (n = 20) and a group performing abdominopelvic exercise with the addition of postural instructions (AEPPI) (n = 20). Primary outcome measures were UI symptoms, UI impact and QoL related to UI (UI-QoL), measured by 48 h Pad Test and International Consultation on Incontinence Questionnaire Short Form (ICIQ-UI-SF), which were assessed at baseline, post-intervention and 3 months follow-up. Secondary outcome was patient’s satisfaction measured by the 100-point Visual Analogic Scale (VAS) only after the intervention. Between-groups differences were observed in terms of UI-QoL immediately after intervention. Within-groups differences were observed between baseline to 3 months follow-up and between post-intervention to 3 months follow-up in AEPPI group (p < 0.05) for UI-QoL and UI impact. UI symptoms were improved in both groups between baseline to 3-months follow-up (p < 0.05). Patient’s satisfaction was higher in the AEPPI group (p < 0.05). The addition of postural instructions to an abdominopelvic exercise program improves UI impact to QoL and patients’ satisfaction in women with SUI.

Highlights

The climacteric phase is defined as the phase marking the transition from the reproductive to the non-reproductive state [1]
A total of 47 women with stress urinary incontinence (SUI) were included in the trial and received either an abdominopelvic exercise program (AEP, n = 23), or an AEP combined with postural instructions (AEPPI, n = 24)
The findings of the present study suggest that both urinary incontinence (UI) symptoms and UI impact show a trend to be reduced when postural instructions are added to an abdominopelvic training program

Summary

Introduction

The climacteric phase is defined as the phase marking the transition from the reproductive to the non-reproductive state (considering the beginning of endocrinological, biological and clinical features of approaching menopause) [1]. According this definition, climacteric includes perimenopause, menopause and postmenopause. Perimenopause period is previous menopause state when the ovaries gradually produces less estrogen and the onset to irregular menstrual cycles. Other symptoms such vaginal atrophy, bladder irritations and urinary incontinence (UI) are usually progressive during climacteric transition [4,5].

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Conclusion