The effect of trunk‐stabilizing muscle training in women with stress urinary incontinence: A randomized controlled trial

Abstract

IntroductionThere is little evidence regarding the effect of trunk‐stabilizing muscles training on the improvement of stress urinary incontinence (SUI) symptoms.ObjectiveTo investigate the effect of trunk‐stabilizing muscles training on trans‐abdominal ultrasonography (TAUS) and clinical urological indices, and on the quality of life (QoL) in women with SUI.DesignRandomized controlled trial.SettingA university hospital.ParticipantsForty‐six women with SUI, aged 20‐55 years, were randomly assigned to experimental (n =23) and control group (n =23).InterventionsThe experimental group performed trunk stabilization exercises according to the Sapsford protocol, while the control group performed pelvic floor muscle (PFM) exercises for eight weeks.Main outcome measuresThe primary outcome measure was bladder base displacement (BBD), assessed by TAUS during PFM contraction (PFMC), Valsalva, and abdominal curl. The secondary outcome measures were PFM strength, the severity of urinary incontinence (UI), voiding diary, and QOL, assessed by the Modified Oxford Grading System, the severity index, frequency chart, and lower urinary tract symptoms‐QOL questionnaire respectively. All variables were assessed at baseline and after 8‐weeks of interventions.ResultsThe interaction of group and time wasn't significant for BBD during PFMC (p=0.98), Valsalva (p=0.28), abdominal curl (p=0.34), and secondary variables (p>0.05). The main effect of time was significant in both groups for BBD during PFMC, PFM strength, the severity of UI, voiding diary, and QoL (p<0.001), with effect size (d) of 0.30, 0.80, 2.05, 1.07, 1.03 in the control; and 0.49, 0.52, 1.75, 0.66, 0.88 in the experimental group respectively. The main effect of the group wasn't significant for BBD during PFMC (p=0.68), Valsalva (p=0.22), abdominal curl (p=0.53), and secondary variables (p>0.05).ConclusionsTrunk‐stabilizing muscles training and PFM exercise are equally effective in the improvement of PFM function, UI symptoms, and QOL in women with SUI. Both methods can be used interchangeably by physical therapists.This article is protected by copyright. All rights reserved.