Presentation Authors: Christine Chu*, Saint Louis, MO, Kathryn Schmitz, State College, PA, Kavita Khanijow, Hannah Stambakio, Diane Newman, Uduak Andy, Lily Arya, Philadelphia, PA
Introduction: Urinary incontinence (UI) is associated with falls and fraility in older women. We have previously shown that this is due to a complex interaction between bladder urgency, physical function, mental anxiety, and physical barriers to reaching the toilet. We developed a home-based combined physical exercise and bladder training with urge suppression program to reduce urgency, improve functional mobility, and decrease falls risk (Exercise UP). Our objective was to assess the feasibility and safety of a randomized controlled trial of a home-based, integrated physical exercise and bladder training program versus usual care in community-dwelling women with UI.
Methods: We conducted a parallel arm, non-blinded, pilot randomized controlled trial of a Exercise UP versus usual care in women aged 65 and older with UI. Women randomized to Exercise UP received DVD and home exercise equipment. All women were provided information on home improvements to reduce falls risk. Outcomes included feasibility (process, resources, management, acceptability), urinary symptoms, and falls risk using self-administered questionnaires. Objective physical activity was measured using accelerometry.
Results: A total of 37/38 (97%) of eligible women were willing to participate in the study. In the Exercise UP group, 17/19 (89%) women completed all 6 weeks of intervention and follow up, and 16/18 (89%) women in the usual care group completed follow up. Ten (53%) women in the Exercise UP group achieved at least 70% adherence to exercise prescription. Improvement in UI severity scores from baseline was greater in the Exercise UP group than the usual care group (-6.2Â±5.8 vs -2.4Â±4.2, p=0.04). Falls risk scores improved in both groups and were not significantly different (p>0.05). There were no significant between-group differences in accelerometer-based measures of physical activity or sedentary behavior (Table 1). No significant adverse events were noted.
Conclusions: We determined that it would be feasible to conduct a home-based exercise intervention in older women with UI. Clinical outcomes were modestly favorable for the Exercise UP group.
Source of Funding: Perelman School of Medicine, University of Pennsylvania