Steenstrup Benoit, Auger Camille, Cornu Jean Nicolas, Gillot Timothee, Fradet Laetitia
Department of Urology, Rouen University Hospital, Rouen, France.
La Musse Physiotherapy Training Institute, Saint Sebastien de Morsent, France.
Int Urogynecol J. 2025 Apr 30. doi: 10.1007/s00192-025-06109-x.
Most women suffering from urinary incontinence (UI) report that leakage occurs during everyday movement. These precise observations raise a potential association between standing postural control and UI. The aim of this systematic review is to compile studies investigating the link between standing postural control and UI, according to the presence or absence of UI, the severity of UI and bladder fullness.
This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Observational studies providing data on standing postural control in women with and without UI were considered for inclusion.
Ten studies met the inclusion criteria, representing 4262 middle-aged and older active women. According to the modified version of the Newcastle-Ottawa quality assessment Scale, one was study rated as having a high risk of bias, 3 studies fair quality and 6 good quality. Four studies reported results using stabilographic measurement (p = 124 women). Six reported results using standing balance tests (p = 4138). All studies revealed some differences between UI and non-UI groups in standing postural control (p < 0.05).
Our analysis provides a high level of evidence that women with UI have more impaired standing postural balance control than women without UI. According to the dual-task theory, worsening continence control is associated with a decline in standing postural balance, and conversely, a decline in standing postural balance is associated with the development of UI. Developing prospective planned physiotherapy intervention studies that address the impact of standing postural control interventions on UI signs and symptoms seems advisable.
大多数患有尿失禁（UI）的女性报告称，在日常活动中会出现漏尿情况。这些确切的观察结果提示站立姿势控制与尿失禁之间可能存在关联。本系统评价的目的是汇总有关站立姿势控制与尿失禁之间联系的研究，依据尿失禁的有无、尿失禁的严重程度以及膀胱充盈情况进行分析。
本系统评价按照系统评价与Meta分析的首选报告项目指南进行。纳入提供有尿失禁和无尿失禁女性站立姿势控制数据的观察性研究。
10项研究符合纳入标准，涉及4262名中老年活跃女性。根据纽卡斯尔-渥太华质量评估量表的修订版，1项研究被评为偏倚风险高，3项研究质量一般，6项研究质量良好。4项研究使用姿势稳定测量法报告结果（n = 124名女性）。6项研究使用站立平衡测试报告结果（n = 4138）。所有研究均显示尿失禁组和非尿失禁组在站立姿势控制方面存在一些差异（p < 0.05）。
我们的分析提供了高水平证据，表明患有尿失禁的女性比无尿失禁的女性在站立姿势平衡控制方面受损更严重。根据双任务理论，控尿能力恶化与站立姿势平衡下降相关，反之，站立姿势平衡下降与尿失禁的发生相关。开展前瞻性计划的物理治疗干预研究，探讨站立姿势控制干预对尿失禁体征和症状的影响似乎是可取的。
