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Physical therapy for urinary incontinence in postmenopausal women with osteoporosis or low bone density

a randomized controlled trial

Sran, Meena PT, PhD; Mercier, Joanie PT, MSc; Wilson, Penny BSR; Lieblich, Pat BPT; Dumoulin, Chantale PT, PhD

doi: 10.1097/GME.0000000000000594
Original Articles
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Objective: To assess the effectiveness of 12 weekly physical therapy sessions for urinary incontinence (UI) compared with a control intervention, for reducing the number of UI episodes measured with the 7-day bladder diary, at 3 months and 1 year postrandomization.

Methods: A single parallel-group randomized controlled trial was conducted at one outpatient public health center, in postmenopausal women aged 55 years and over with osteoporosis or low bone density and UI. Women were randomized to physical therapy (PT) for UI or osteoporosis education. The primary outcome measure was number of leakage episodes on the 7-day bladder diary, assessed at baseline, after treatment and at 1 year. The secondary outcome measures included the pad test and disease-specific quality of life and self-efficacy questionnaires assessed at the same timepoints.

Results: Forty-eight women participated (24 per group). Two participants dropped out of each group and one participant was deceased before 3-month follow-up. Intention-to-treat analysis was undertaken. At 3 months and 1 year, there was a statistically significant difference in the number of leakage episodes on the 7-day bladder diary (3 mo: P = 0.04; 1 y: P = 0.01) in favor of the PT group. The effect size was 0.34 at 1 year. There were no harms reported.

Conclusions: After a 12-week course of PT once per week for UI, PT group participants had a 75% reduction in weekly median number of leakage episodes, whereas the control group's condition had no improvement. At 1 year, the PT group participants maintained this improvement, whereas the control group's incontinence worsened.

1BC Women's Hospital & Health Centre, Vancouver, British Columbia, Canada

2School of Rehabilitation, Faculty of Medicine

3Research Centre of the Institut Universitaire de Gériatrie de Montréal, University of Montreal, Quebec, Canada.

Address correspondence to: Chantale Dumoulin, PT, PhD, Research Centre of the Institut Universitaire de Gériatrie de Montréal, 4565 ch. Queen-Mary, Montreal, poste 4153, Québec H3W 1W5, Canada. E-mail: chantal.dumoulin@umontreal.ca

Received 15 July, 2015

Revised 10 November, 2015

Accepted 10 November, 2015

Funding/support: This study was funded by the BC Women's Health Research Institute, Doris Winterbottom Research Award.

Financial disclosure/conflicts of interest: None reported.

© 2016 by The North American Menopause Society.