GRADED PELVIC MUSCLE EXERCISE - EFFECT ON STRESS URINARY-INCONTINENCE

The purpose of this research was to determine the effect of pelvic muscle exercise (PME) on stress urinary incontinence in middle-aged and elderly women. The protocol required 16 weeks of exercise three times per week, for a total of 48 sessions. Measures were taken at baseline, after a 4-week control period and after 4, 8, 12 and 16 weeks of PME, corresponding to PME levels 1, 2, 3 and 4, respectively. Urine loss was evaluated using a urinary diary and 24-hour pad test at baseline, after the control period and after PME levels 2 and 4. Pelvic muscle function was evaluated every four weeks. Sixty-five parous women 35-75 years of age (mean, 51.3) with mild to moderate stress urina incontinence were studied. No significant changes in the outcome variables were found after the control period. The results showed significant reductions in urine loss on the 24-hour pad test (t = - 4.7, P less-than-or-equal-to .0001), and episodes of urine loss decreased from 2.6 to 1.0 between the control period and PME level 4. In addition, a significant improvement occurred in pressures developed by the pelvic muscles in response to PME (t = 6.8, P less-than-or-equal-to .0001). Significant correlations between changes in pelvic muscle pressure and in urine loss variables were not found. Women who completed the study experienced a significant reduction in the amount of urine loss as well as a significant increase in pelvic muscle characteristics. The low correlation between changes in urine loss and pelvic muscle pressures suggests that the mechanisms by which pelvic muscle contractions affect stress incontinence are not explained fully by pressure changes measured intravaginally. The study also found a significant improvement in incontinence results from a PME protocol of lower intensity and frequency than those previously reported.