Structured behavioral treatment research protocol for women with mixed urinary incontinence and overactive bladder symptoms

Newman, Diane K.; Borello‐France, Diane; Sung, Vivian W.

doi:10.1002/nau.23244

Cited by 29 publications

(29 citation statements)

References 49 publications

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“…However, teaching people to resist bowel urgency sensations and postpone evacuation has not yet been subject to rigorous research 5 • Bowel urgency may induce feelings of anxiety or panic, which affects ability to concentrate 32 reinforces the person's ability to hold off and the success of urge suppression in a safe environment. • A study of internal anal sphincter pressure wave patterns in 72 adults showed relaxation breathing promotes more regular pressure wave patterns and may aid in reducing fecal urgency and incontinence 54 • Learning to 'stop & squeeze' 41 and experiencing success positively reinforces the chosen urge suppression technique and may lead to improved control of faecal urgency/incontinence • Explanations for bladder training effects include diverting attention away from the urgency sensation using competing mentally demanding activities. 21 This proposed mechanism may be equally applicable to bowel training ➤ The healthcare practitioner positively reinforces the person's continence skills and improved and/or prolonged bowel control.…”

Section: Discussionmentioning

confidence: 99%

Consensus statement on bladder training and bowel training

Booth

2020

Neurourology and Urodynamics

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Aim This consensus statement synthesizes evidence to guide healthcare professionals on promoting consistent, cohesive and achievable bladder training for people with overactive bladder/urgency urinary incontinence and bowel training for those with urgency fecal incontinence. Methods The Consensus Statement on Bladder and Bowel Training was developed by a sub‐group of the International Continence Society Nursing Committee and an expert panel, who formed a virtual Consultation Group. Review of published research, expert opinion articles, policy statements, and voluntary professional group information identified existing recommendations, from which statements were formulated and organized. A modified Delphi process was used to reach consensus on each statement, involving three rounds of virtual consultation. Consultation Group members indicated agreement/disagreement with each statement. Statements, or changes, were accepted when consensus was reached, defined as agreement by 80% of the Consultation Group. Results No universal definition of bladder training or bowel training was found, therefore a consensus definition was developed and agreed for each. Limited high quality studies of bladder training were identified and no studies investigating the use or effectiveness of bowel training for urgency fecal incontinence in adults. Broad‐ranging evidence suggests both types of training should include four elements, personalized to individual need and situation: information and education; a prescribed voiding/evacuation regimen based on individually identified patterns of bladder or bowel functioning; progression of voiding/evacuation regimen; ongoing support and reinforcement. Conclusions These consensus statements will support healthcare practitioners to design and deliver consistent bladder and bowel training. Improved evidence on mechanisms and effectiveness is needed to inform practice.

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Section: Discussionmentioning

confidence: 99%

Consensus statement on bladder training and bowel training

Booth

2020

Neurourology and Urodynamics

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“…In a recent randomized controlled trial (RCT) of 307 older adults, FlexToBa was found to be “enjoyable,” safe and efficacious for improving balance and function . A DVD on bladder training with urge suppression and behavioral measures was developed by a nurse practitioner with extensive experience in behavioral management of UI . Finally, the intervention included a home visit during which a trained study coordinator provided written recommendations for home improvement using a checklist for falls prevention in older adults developed by the Center for Disease Control and Prevention (CDC)…”

Section: Methodsmentioning

confidence: 99%

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

Chu

Schmitz

Khanijow

et al. 2019

Neurourology and Urodynamics

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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.

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“…Visual observation can be used to assess a correct pelvic floor muscle contraction, which is seen by perineal elevation, or an incorrect contraction observed by perineal descent in women (Bo et al, 2017). Digital palpation, such as the Brink score and the Laycock power, endurance, repetitions, fast, every, contraction, timed (PERFECT) assessment scheme is the most used method in clinical practice (Laycock and Jerwood, 2001;Newman and Wein, 2013;Newman et al, 2018). The Brink score employs a 4-point scale to assess the contraction pressure, vertical displacement, and endurance of squeeze (Brink et al, 1989).…”

Section: Evaluations Of Pelvic Floor Musclesmentioning

confidence: 99%

Pelvic floor muscle exercise and training for coping with urinary incontinence

Cho¹,

Kim²

2021

J Exerc Rehabil

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The pelvic floor consists of levator ani muscles including puborectalis, pubococcygeus and iliococcygeus muscles, and coccygeus muscles. Pelvic floor muscle exercise (PFME) is defined as exercise to improve pelvic floor muscle strength, power, endurance, relaxation, or a combination of these parameters. PFME strengthens the pelvic floor muscles to provide urethral support to prevent urine leakage and suppress urgency. This exercise has been recommended for urinary incontinence since first described by Kegel. When treating urinary incontinence, particularly stress urinary incontinence, PFME has been recommended as first-line treatment. This article provides clinical application of PFME as a behavioral therapy for urinary incontinence. Clinicians and physical therapist should understand pelvic floor muscle anatomy, evaluation, regimen, and instruct patients how to train the muscles properly.

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Structured behavioral treatment research protocol for women with mixed urinary incontinence and overactive bladder symptoms

Abstract: This paper details a perioperative behavioral/pelvic floor exercise intervention research study protocol developed for women undergoing surgery for MUI.

Cited by 29 publications

References 49 publications

Consensus statement on bladder training and bowel training

Consensus statement on bladder training and bowel training

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

Pelvic floor muscle exercise and training for coping with urinary incontinence

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