1. Physical therapy for urinary incontinence in postmenopausal women with osteoporosis or low bone density
- Author
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Meena Sran, Chantale Dumoulin, Pat Lieblich, Penny Wilson, Joanie Mercier, and Université de Montréal. Faculté de médecine. École de réadaptation
- Subjects
medicine.medical_specialty ,Bone density ,Osteoporosis ,Urinary incontinence ,030232 urology & nephrology ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Patient Education as Topic ,Randomized controlled trial ,Bone Density ,law ,Surveys and Questionnaires ,Outcome Assessment, Health Care ,Low bone density ,Humans ,Medicine ,030212 general & internal medicine ,Osteoporosis, Postmenopausal ,Physical Therapy Modalities ,Aged ,Postmenopausal women ,Pelvic floor ,Intention-to-treat analysis ,business.industry ,Obstetrics and Gynecology ,Pelvic Floor ,Pelvic floor muscle training ,Middle Aged ,medicine.disease ,Intention to Treat Analysis ,medicine.anatomical_structure ,Aging women ,Physical therapy ,Female ,medicine.symptom ,business - Abstract
Objective: To assess the effectiveness of 12 weekly physical therapy sessions for urinary incontinence (UI) compared with a control intervention, for reducing the number of UI episodes measured with the 7-day bladder diary, at 3 months and 1 year postrandomization. Methods: A single parallel-group randomized controlled trial was conducted at one outpatient public health center, in postmenopausal women aged 55 years and over with osteoporosis or low bone density and UI. Women were randomized to physical therapy (PT) for UI or osteoporosis education. The primary outcome measure was number of leakage episodes on the 7-day bladder diary, assessed at baseline, after treatment and at 1 year. The secondary outcome measures included the pad test and disease-specific quality of life and self-efficacy questionnaires assessed at the same timepoints. Results: Forty-eight women participated (24 per group). Two participants dropped out of each group and one participant was deceased before 3-month follow-up. Intention-to-treat analysis was undertaken. At 3 months and 1 year, there was a statistically significant difference in the number of leakage episodes on the 7-day bladder diary (3 mo: P = 0.04; 1 y: P = 0.01) in favor of the PT group. The effect size was 0.34 at 1 year. There were no harms reported. Conclusions: After a 12-week course of PT once per week for UI, PT group participants had a 75% reduction in weekly median number of leakage episodes, whereas the control group's condition had no improvement. At 1 year, the PT group participants maintained this improvement, whereas the control group's incontinence worsened.
- Published
- 2016
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