Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes

Abstract

BackgroundResidents in nursing homes (NHs) are often frail older persons who have impaired physical activity. Urinary incontinence (UI) is a common complaint for residents in NHs. Reduced functional ability and residence in NHs are documented to be risk factors for UI.ObjectiveTo investigate if an individualized training program designed to improve activity of daily living (ADL) and physical capacity among residents in nursing homes has any impact on UI.Materials and methodsThis randomized controlled trial was a substudy of a Nordic multicenter study. Participants had to be >65 years, have stayed in the NH for more than 3 months and in need of assistance in at least one ADL. A total of 98 residents were randomly allocated to either a training group (n = 48) or a control group (n = 50) after baseline registrations. The training program lasted for 3 months and included accommodated physical activity and ADL training. Personal treatment goals were elicited for each subject. The control group received their usual care. The main outcome measure was UI as measured by a 24-hour pad-weighing test. There was no statistically significant difference between the groups on this measure at baseline (P = 0.15). Changes were calculated from baseline to 3 months after the end of the intervention.ResultsAltogether, 68 participants were included in the analysis, 35 in the intervention group and 33 in the control group. The average age was 84.3 years. The 3 months’ postintervention adjusted mean difference between groups according to amount of leakage was 191 g (P = 0.03). This result was statistically significant after adjusting for baseline level, age, sex, and functional status. The leakage increased in residents not receiving the experimental intervention, while UI in the training group showed improvement.ConclusionThe intervention group had significant better results compared with the control group after an individualized training program designed to improve ADL and physical capacity. Further studies are needed to evaluate the effect of a goal-oriented physical training program toward NH residents UI complaints.

Prevalence and correlates of fecal incontinence among nursing home residents: a population-based cross-sectional study

“…However, a Norwegian study showed a significant decrease in urine leakage among residents participating in an individualized training program designed to improve ADL and physical capacity. By actively training residents, worsening of urinary incontinence was prevented or reduced [42]. Prompted toileting has been tested for dementia-related fecal incontinence, but the results were not convincing [43].…”

Extubation process in bed-ridden elderly intensive care patients receiving inspiratory muscle training: a randomized clinical trial

“…As people age, there is a gradual reduction in pulmonary performance, and in elderly people these physiological alterations can seriously impact cardiorespiratory functional reserve 1. In addition, respiratory muscle strength is also affected by poor nutrition and sarcopenia, both of which are associated with aging and bedridden patients 2–4…”

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

“…A treatment approach that integrates strength and balance training with bladder training that includes urge suppression strategies would address each level of the biopsychoecological model and could potentially improve both UI and risk for falls. However, the studies that have previously investigated the impact of physical training on UI and mobility were performed in institutionalized older adults . Significant differences in functional fitness and physical activity participation between institutionalized and community‐dwelling adults limit the generalizability of the current data.…”

“…However, the studies that have previously investigated the impact of physical training on UI and mobility were performed in institutionalized older adults. 8,9 Significant differences in functional fitness and physical activity participation between institutionalized and community-dwelling adults limit the generalizability of the current data. Thus, structured programs that aim to reduce falls risk and urinary symptoms in community-based older women with UI are lacking.…”