Feasibility and outcomes: Pilot Randomized Controlled Trial of a home‐based integrated physical exercise and bladder‐training program vs usual care for community‐dwelling older women with urinary incontinence

Abstract

Aims 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). Methods 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. Results 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. Conclusions 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.

Patterns of sedentary behavior among older women with urinary incontinence and urinary symptoms: a scoping review

“…Seven studies, namely, three experimental trials [ 39 – 41 ], three cross-sectional studies [ 4 , 26 , 42 ], and one secondary data analysis [ 25 ], were published between 2015 and 2023 and were conducted in four regions or countries, including Spain [ 4 , 42 ], the United States [ 25 , 40 , 41 ], Malaysia [ 26 ], and Taiwan [ 39 ]. The sample sizes ranged from 33 to 712, with 1,822 female participants, and age varied from 64 to 97 years.…”

“…Given that one of the included studies might have wrongly reported the sedentary time as they might have considered sleeping time (i.e., sedentary time exceeded 1000 min/day) [ 40 ], the sedentary behavior data measured by accelerometers derived from this study were not reported in the present review. Their objectively measured sedentary time varied from 493.3 to 508.4 min/day that accounted for around 73% of their waking time (Table 1 ) [ 25 , 41 ], while self-reported sitting time on weekdays was 300–380 min/day (Table 2 ) [ 39 , 40 ].…”

“…Their objectively measured sedentary time varied from 493.3 to 508.4 min/day that accounted for around 73% of their waking time (Table 1 ) [ 25 , 41 ], while self-reported sitting time on weekdays was 300–380 min/day (Table 2 ) [ 39 , 40 ].…”

“…The step counts of the participants ranged from 2117.75 steps/day to 2671.7 steps/day (Table 1 ) [ 25 , 40 , 41 ], which were fewer than 5000 steps/day and therefore considered sedentary [ 21 , 43 , 44 ]. Notably, daily steps declined considerably with age from 2716.1 steps/day in individuals aged 65–69 years to 755.3 steps/day in those aged 90 years or older, but no obvious association was found between self-reported sitting time and advanced age [ 40 ].…”

Reducing Falls in Older Women with Urinary Incontinence

“…The Health Integration Theory, which posits that although the foci of illness and injury are within the body and mind, the physical and social environments contain elements that can cause or exacerbate disease and lead to injuries and disabilities [ 31 ]. Considering this framework, we have developed a bio-psycho-ecological model ( Figure 1 ) in which falls in women with UUI are the result of a complex interaction between physical, mental, social, and environmental factors [ 32 ]. In addition to physical weakness, older women may have anxiety associated with making it to the restroom, societal roles or occupations that limit bathroom access, or environmental safety hazards that increase the risk of falls [ 6 ].…”