Abstract
Background: Improving pelvic floor muscle training (PFMT), balance and functional activity is recommended in the treatment of ürinary incontinence(UI) in the elderly. The aim of this study is to examine whether PFMT combined with Otago exercises is effective on symptoms, balance and functional status in elderly people with UI, compared to PFMT alone.
Methods: This study is an assessor‐blinded, randomized controlled trial. Participants with UI aged 65 and over living in a nursig home were randomly assigned to intervention (IG) and control group (CG). The intervention group attended an exercise program that included Otago exercises combined with PFMT. The control group was included in the PFMT program with different positions. Duration of exercise for both groups was 45-60 minutes per session three times a week for 12 weeks. UI symptoms and severity (Pelvic Floor Distress Inventory-20, bladder diary), PFM muscle function (superficial electromyography), balance (Berg Balance Scale), functional status (Senior Fitness Test) and fear of falling (Falls Efficacy Scale) was measured at baseline and after the intervention.
Results: The median age of the IG (n:22) and CG (n:21) was 73.5 and 77, respectively. At baseline and after the intervention within the group, a significant improvement was observed in the PTDE-20 score (IG and CG, p:0.00) and the 2-minute step test in the IG (p:0.02) and CG (p:0.01). A significant decrease was found in the 2.45m get up and go test, PFM work MVC, PFM work average onset, and PFM rest MVC EMG values (p:0.01, p:0.02, p:0.01, p:0.00) in the IG. PFM rest average value was decreased (p:0.04) in the CG.
Conclusion: Considering the fact that functional type (stress and urge type) incontinence is common in the elderly people, both incontinence and functional mobility can be improved more effectively by combining two proven practices in the treatment of incontinence.