School of Rehabilitation, Faculty of medecine, Université de Montréal, Montreal, Quebec, Canada.
Montreal Geriatric Institute Research Center, Montreal, Quebec, Canada.
Neurourol Urodyn. 2020 Feb;39(2):642-649. doi: 10.1002/nau.24234. Epub 2019 Nov 25.
The fall rate in urgency urinary incontinence (UUI) and mixed UI (MUI) older women is higher when compared with that of continent women. One hypothesis is that a strong desire to void (SDV) could alter gait parameters and therefore increase the risk of falls. The aim of this study was to investigate and compare the effect of SDV on gait parameters in UUI/MUI and continent older women who experienced falls. The secondary aim was to determine the relationship between UI severity and gait parameters in incontinent women.
A quasi-experimental pilot study was conducted with two groups of healthy community-dwelling women who experienced at least one fall in the last year: continent (n = 17; age: 74.1 ± 4.3) and UUI/MUI (n = 15; age: 73.5 ± 5.9). We recorded, analyzed, and compared spatiotemporal gait parameters for participants in each group with both SDV and no desire to void condition.
A pattern of reduced velocity (P = 0.05) and stride width (P = 0.02) was observed in both groups with SDV. Incontinence severity was correlated with reduced velocity (r = -0.63, P = 0.01), increased stance time (r = 0.65, P = .01) and stance time variability (r = 0.65, P = .01) in no desire to void condition and with reduced velocity (r = -0.56, P = .03) and increased stride length variability (r = 0.54, P = .04) in SDV condition.
SDV reduced gait velocity and stride width regardless of continence status in older women at risk of falls. Further, UI severity in the UUI/MUI women was correlated to reduced gait velocity and increased variability. Our findings could explain the higher fall rate in this population.
与无尿失禁（UI）的女性相比，急迫性 UI（UUI）和混合性 UI（MUI）老年女性的跌倒率更高。有一种假设是，强烈的排尿欲望（SDV）可能会改变步态参数，从而增加跌倒的风险。本研究旨在调查和比较有 SDV 和无 SDV 时 UUI/MUI 和有 UI 但无跌倒史的老年女性的步态参数的影响。次要目的是确定尿失禁严重程度与尿失禁女性步态参数的关系。
进行了一项具有两个组的准实验性试点研究，这两个组均为在过去一年中至少跌倒过一次的健康社区居住的女性：无尿失禁（n=17；年龄：74.1±4.3）和 UUI/MUI（n=15；年龄：73.5±5.9）。我们记录、分析和比较了两组参与者在有 SDV 和无 SDV 时的时空步态参数。
两组参与者在有 SDV 时，速度（P=0.05）和步幅宽度（P=0.02）均呈降低模式。无 SDV 时，尿失禁严重程度与速度降低（r=-0.63，P=0.01）、站立时间延长（r=0.65，P=0.01）和站立时间变异性增加（r=0.65，P=0.01）相关，而有 SDV 时，尿失禁严重程度与速度降低（r=-0.56，P=0.03）和步长变异性增加（r=0.54，P=0.04）相关。
无论是否存在尿失禁，有跌倒风险的老年女性的 SDV 均会降低其步态速度和步幅宽度。此外，UUI/MUI 女性的尿失禁严重程度与步态速度降低和变异性增加相关。我们的发现可以解释该人群跌倒率较高的原因。
