Effects Of Pelvic Floor Muscle Exercises In Japanese Elderly Women With A History Of Urinary Incontinence

Abstract

The most common treatments for urinary incontinence include surgery, drug therapies, and behavioral interventions. Behavioral interventions such as pelvic floor muscle exercises and bladder training have potential benefits with few risks and no side effects. PURPOSE To examine the effect of a 3–month pelvic floor muscle training program in community-dwelling Japanese elderly women with a history of urinary incontinence. METHODS After obtaining informed consent, the 70 positive respondents were randomized to an intervention group (n = 35) and a control group (n = 35). Baseline assessment consisted of interview survey and functional fitness tests. The intervention program consisted of 60–minute exercise sessions held at the TMIG Health Promotion Center twice a week for 12 weeks. The exercises consisted: 1) Warm-up and stretching; 2) Pelvic floor muscle strength training: the exercise regimen was designed to strengthen fast- and slow-twitch muscle fibers located in the pelvic floor; and 3) Functional exercises for the pelvic floor muscle: body awareness, breathing, relaxation exercise, and strength training of the thigh, abdominal, and back muscles. RESULTS There were significant (P<0.05) increases in adductor magnus muscle strength (sitting and lying position), and maximal walking speed after the 3-month pelvic floor muscle exercises in the intervention group. Sixteen women (16/29, 55.2%) in the intervention group reported being continent after the intervention. The percentage of those avoiding going out due to worry over urine loss was significantly (P=0.004) decreased from 44.8% at baseline to 13.8% after the trial. There was also a significant (P=0.039) decrease in the percentage of restricted social contact caused by urine loss from 34.5% at baseline to 10.3%, and the percentage of those with constipation decreased significantly (P=0.016) from 51.7% at baseline to 27.6% after the 3-month exercises. SUMMARY The results suggest that a health promotion trial including pelvic floor muscle and progressive muscle strength training, if conducted as part of a carefully monitored protocol, is a safe and effective method to improve urine loss in community-dwelling Japanese elderly people with a history of urinary incontinence.