Department of Physiatry, Balneology, and Medical Rehabilitation, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.
Department of Medical Rehabilitation, Hospital Košice-Šaca a.s., 1st private hospital, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia.
Z Gerontol Geriatr. 2022 Feb;55(1):51-60. doi: 10.1007/s00391-021-01942-3. Epub 2021 Jul 26.
The primary aim of the work was to evaluate the effect of physical training and pelvic floor muscle training combined with dual tasks (PFMT-DT) in older women on urgency urinary incontinence (UUI). The secondary aim of the work was to evaluate the impact of interventions on static and dynamic balance, risk of falls and fear of falls.
The research sample consisted of 88 older women with UUI, with a mean age of 75 ± 4.3 years. They were randomly divided into two groups: the experimental (n = 40) and control (n = 40) groups.
The duration of the intervention was 12 weeks. Both groups underwent physical training three times a week for 30 minutes. In addition, the experimental group received pelvic floor muscle training in different positions and with dual cognitive tasks two times a week for 30 minutes. We used The International Consultation on Incontinence Questionnaire (ICIQ-UI SF), the modified Voiding Diary, and the Overactive Bladder Questionnaire(OAB-q). The risk of falls were assessed according to Tinetti's Performance Oriented Mobility Assessment. Fear of falls was assessed by the Falls Efficacy Scale.
After the treatment, significant differences between groups were recorded in favor of the experimental group in the daytime frequency of voiding (7.6 to 5.3), in nycturia (2.1 to 0.7), in UUI (1.8 to 1.0), OAB-q SS (40.8 to 17.6) and OAB-q HR (61.2 to 83.8) (p ≤ 0.001), with large effect size (ES), as well as in the Tinetti balance and gait and in the fall risk assessment (19.2 to 23.2) (p ≤ 0.001), also with a large ES. For fear of falls, significant differences were noted (80.0 to 71.5) (p ≤ 0.05), with a small ES in favor of the experimental group.
The PFMT-DT proved to be an effective intervention in improving the symptoms of OAB and UUI. We were able to significantly reduce the risk of falls according to POMA by about 21% (19.2 ± 2.7 to 23.20 ± 3.25%) in older women with UUI.
本研究的主要目的是评估身体训练和结合双重任务的骨盆底肌肉训练（PFMT-DT）对老年女性急迫性尿失禁（UUI）的影响。本研究的次要目的是评估干预措施对静态和动态平衡、跌倒风险和跌倒恐惧的影响。
研究样本由 88 名患有 UUI 的老年女性组成，平均年龄为 75±4.3 岁。她们被随机分为两组：实验组（n=40）和对照组（n=40）。
干预持续 12 周。两组均每周进行 3 次、每次 30 分钟的身体训练。此外，实验组每周进行 2 次、每次 30 分钟的不同体位骨盆底肌肉训练和认知双重任务训练。我们使用国际尿失禁咨询问卷简表（ICIQ-UI SF）、改良排尿日记和膀胱过度活动症问卷（OAB-q）。根据 Tinetti 活动能力评估量表评估跌倒风险。使用跌倒效能量表评估跌倒恐惧。
治疗后，实验组日间排尿频率（7.6 次至 5.3 次）、夜间排尿次数（2.1 次至 0.7 次）、UUI 次数（1.8 次至 1.0 次）、OAB-q SS（40.8 分至 17.6 分）和 OAB-q HR（61.2 分至 83.8 分）均显著优于对照组（p≤0.001），差异具有统计学意义，且具有较大的效应量（ES）；Tinetti 平衡和步态以及跌倒风险评估（19.2 分至 23.2 分）也显著优于对照组（p≤0.001），且 ES 较大。在跌倒恐惧方面，实验组（80.0 分至 71.5 分）也显著低于对照组（p≤0.05），ES 较小。
PFMT-DT 被证明是改善 OAB 和 UUI 症状的有效干预措施。我们能够通过 POMA 将患有 UUI 的老年女性的跌倒风险降低约 21%（19.2±2.7 分至 23.20±3.25%）。
