Department of Obstetrics and Gynecology, Washington University in St Louis, St Louis, Missouri.
Department of Public Health Sciences, Penn State College of Medicine, Hershey, Pennsylvania.
Neurourol Urodyn. 2019 Jun;38(5):1399-1408. doi: 10.1002/nau.23999. Epub 2019 Apr 18.
To assess the feasibility of a randomized controlled trial of a home-based integrated physical exercise and bladder-training program vs usual care in community-dwelling women with urinary incontinence (UI).
We conducted a parallel arm, nonblinded, pilot randomized controlled trial of a home-based integrated physical exercise and bladder training with urge suppression and fall prevention program (ExerciseUP) vs usual care in women aged 65 and older with UI. Outcomes included feasibility (process, resources, management, and acceptability), urinary symptoms, and falls risk using self-administered questionnaires. Objective physical activity was measured using accelerometry.
A total of 37 of 38 (97%) eligible women were willing to participate in the study. In the ExerciseUP intervention cohort, 17 of 19 (89%) women completed all 6 weeks of intervention and follow-up, and 16 of 18 (89%) women in the usual group completed follow-up. Ten (53%) women in the ExerciseUP group achieved at least 70% adherence to exercise prescription. The improvement in UI severity scores from baseline was greater in the ExerciseUP intervention group than the usual care group (- 6.2 ± 5.8 vs - 2.4 ± 4.2, P = 0.04). Fall-risk score decreased (improved) in both groups. There were no significant between-group differences in change in physical activity or sedentary behavior.
We determined that it would be feasible to conduct a home-based exercise intervention in older women with UI. Our clinical outcomes were modestly favorable for the ExerciseUP intervention group.
评估一项针对社区居住的尿失禁(UI)女性的基于家庭的综合体育锻炼和膀胱训练计划与常规护理的随机对照试验的可行性。
我们进行了一项平行臂、非盲、试点随机对照试验,比较了基于家庭的综合体育锻炼和膀胱训练联合抑制急迫性和预防跌倒的方案(ExerciseUP)与常规护理对年龄在 65 岁及以上的 UI 女性的效果。使用自我管理问卷评估了可行性(过程、资源、管理和可接受性)、尿失禁症状和跌倒风险。使用加速度计测量了客观身体活动。
共有 38 名符合条件的女性中的 37 名(97%)愿意参加研究。在 ExerciseUP 干预组中,19 名女性中有 17 名(89%)完成了所有 6 周的干预和随访,而在常规组中,18 名女性中有 16 名(89%)完成了随访。在 ExerciseUP 组中,有 10 名(53%)女性至少有 70%的运动处方依从性。与常规护理组相比,ExerciseUP 干预组的 UI 严重程度评分从基线的改善更大(-6.2±5.8 对-2.4±4.2,P=0.04)。两组的跌倒风险评分均有所下降。两组之间在身体活动或久坐行为的变化方面没有显著差异。
我们确定对患有 UI 的老年女性进行基于家庭的运动干预是可行的。我们的临床结果对 ExerciseUP 干预组是适度有利的。