Effects of Pelvic Floor Muscle Exercise on Urinary Incontinence in Elderly Women With Cognitive Impairment
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Purpose: Pelvic floor muscle exercise (PFME) is a therapeutic option for urinary incontinence (UI). However, studies of the efficacy of PFME on UI in patients with cognitive impairment (CI) are lacking. Therefore, we evaluated the effect of PFME on UI in elderly women with mild CI. Methods: A total of 150 women with mild CI or Alzheimer disease and UI were screened using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Cognitive function and behavioral symptoms were evaluated by the Mini-Mental State Examination and Barthel’s Activities of Daily Living. The patients were randomly divided into a control group (n=46) and a PFME group (n=52, 6 sessions of PFME for 12 weeks). The primary outcome was the change in UI episodes measured with a frequency volume chart (FVC). The secondary outcomes were other FVC parameters and the ICIQ-SF scores. Results: A total of 82 women (control group: 40 and PFME group: 42) completed the study. After 12 weeks of PFME, the mean number of UI episodes per 24 hours decreased by 1.6 (from 3.3 to 1.7) in the PFME group and by 0.5 (from 3.4 to 2.9) in the control group (P<0.001 between groups). The mean number of micturition episodes and total ICIQ-SF scores improved in the PFME group to a significantly greater extent than in the control group (P<0.001). Conclusions: Supervised PFME can be a good therapeutic option for improving UI in elderly women with CI.
Abstract
Purpose: Pelvic floor muscle exercise (PFME) is a therapeutic option for urinary incontinence (UI). However, studies of the efficacy of PFME on UI in patients with cognitive impairment (CI) are lacking. Therefore, we evaluated the effect of PFME on UI in elderly women with mild CI. Methods: A total of 150 women with mild CI or Alzheimer disease and UI were screened using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Cognitive function and behavioral symptoms were evaluated by the Mini-Mental State Examination and Barthel’s Activities of Daily Living. The patients were randomly divided into a control group (n=46) and a PFME group (n=52, 6 sessions of PFME for 12 weeks). The primary outcome was the change in UI episodes measured with a frequency volume chart (FVC). The secondary outcomes were other FVC parameters and the ICIQ-SF scores. Results: A total of 82 women (control group: 40 and PFME group: 42) completed the study. After 12 weeks of PFME, the mean number of UI episodes per 24 hours decreased by 1.6 (from 3.3 to 1.7) in the PFME group and by 0.5 (from 3.4 to 2.9) in the control group (P<0.001 between groups). The mean number of micturition episodes and total ICIQ-SF scores improved in the PFME group to a significantly greater extent than in the control group (P<0.001). Conclusions: Supervised PFME can be a good therapeutic option for improving UI in elderly women with CI.
참고문헌 (23)
- Panza F, "Cognitive frailty : a systematic review of epidemiological and neurobiological evidence of an age-related clinical condition", Rejuvenation Res, 18, pp.389~412 (2015)
- Markland AD, "Incontinence", Med Clin North Am, 95, pp.539~554 (2011)
- 정하범, "A current perspective on geriatric lower urinary tract dysfunction", Investigative and Clinical Urology, 56(4), pp.266~275 (2015), 대한비뇨기과학회
- Campbell AJ, "Incontinence in the elderly : prevalence and prognosis", Age Ageing, 14, pp.65~70 (1985)
- Offermans MP, "Prevalence of urinary incontinence and associated risk factors in nursing home residents : a systematic review", Neurourol Urodyn, 28, pp.288~294 (2009)
- Erekson EA, "Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction", Int Urogynecol J, 26, pp.823~830 (2015)
- Parker D, "Effectiveness of interventions that assist caregivers to support people with dementia living in the community : a systematic review", Int J Evid Based Healthc, 6, pp.137~172 (2008)
- Drennan VM, "Conservative interventions for incontinence in people with dementia or cognitive impairment, living at home: a systematic review", BMC Geriatr, 12, pp.77~ (2012)
- Clague F, "Comorbidity and polypharmacy in people with dementia: insights from a large, population-based cross-sectional analysis of primary care data", Age Ageing, 46, pp.33~39 (2017)
- Orme S, "Managing urinary incontinence in patients with dementia : pharmacological treatment options and considerations", Drugs Aging, 32, pp.559~567 (2015)
- Parker WP, "Nonsurgical treatment of urinary incontinence in elderly women", Clin Geriatr Med, 31, pp.471~485 (2015)
- Betschart C, "Pelvic floor muscle training for urinary incontinence : a comparison of outcomes in premenopausal versus postmenopausal women", Female Pelvic Med Reconstr Surg, 19, pp.219~224 (2013)
- Nygaard CC, "Impact of menopausal status on the outcome of pelvic floor physiotherapy in women with urinary incontinence", Int Urogynecol J, 24, pp.2071~2076 (2013)
- Ransmayr GN, "Lower urinary tract symptoms in dementia with Lewy bodies, Parkinson disease, and Alzheimer disease", Neurology, 70, pp.299~303 (2008)
- Lee SH, "Urinary incontinence in patients with Alzheimer’s disease : relationship between symptom status and urodynamic diagnoses", Int J Urol, 21, pp.683~687 (2014)
- Kunkle CM, "Prevalence of cognitive impairment in older women with pelvic floor disorders", Int Urogynecol J, 28, pp.1645~1650 (2017)
- Adkins VK, "Prompted voiding to reduce incontinence in community-dwelling older adults", J Appl Behav Anal, 30, pp.153~156 (1997)
- Jirovec MM, "Predicting success using individualized scheduled toileting for memory-impaired elders at home", Res Nurs Health, 24, pp.1~8 (2001)
- Engberg S, "Effectiveness of prompted voiding in treating urinary incontinence in cognitively impaired homebound older adults", J Wound Ostomy Continence Nurs, 29, pp.252~265 (2002)
- Kaya S, "Short-term effect of adding pelvic floor muscle training to bladder training for female urinary incontinence : a randomized controlled trial", Int Urogynecol J, 26, pp.285~293 (2015)
- Sherburn M, "Incontinence improves in older women after intensive pelvic floor muscle training : an assessor-blinded randomized controlled trial", Neurourol Urodyn, 30, pp.317~324 (2011)
- Hay-Smith EJ, "Comparisons of approaches to pelvic floor muscle training for urinary incontinence in women", Cochrane Database Syst Rev, (12), pp.CD009508~ (2011)
- Alewijnse D, "Predictors of intention to adhere to physiotherapy among women with urinary incontinence", Health Educ Res, 16, pp.173~186 (2001)