title: Incontinence improves in older women after intensive pelvic floor muscle training: an assessor-blinded randomized controlled trial.
abstract: OBJECTIVE
  To test the hypotheses that high intensity pelvic floor muscle training (PFMT) is effective in relief of stress urinary incontinence in community dwelling older women, and that intense PFMT improves stress urinary incontinence more than bladder training (BT) in this population.
  
  
  METHODS
  A two-center, assessor-blinded randomized controlled trial of 20 weeks duration with two active intervention arms: PFMT and BT. Assessments and interventions were undertaken at two metropolitan tertiary hospitals. Participants were community dwelling women over 65 years of age with urodynamic stress incontinence. Primary outcome measure was urinary leakage during a cough stress test. Secondary outcome measures included symptoms and bother (ICIQ-UI SF), participant global perception of change, leakage episodes (7-day accident diary), degree of "bother" (VAS) and health related quality of life (AQoL).
  
  
  RESULTS
  Eighty-three Caucasian women, 71.8 (SD 5.3) years participated in the study. Both groups improved over the intervention period; however, the PFMT group reported significantly lower amounts of leakage on the stress test [PFMT median 0.0 g, 95% CI: 0.2-0.9; BT median 0.3 g, 95% CI: 0.2-1.7, P=0.006], improved symptoms and bother [PFMT mean 5.9, 95% CI: 4.8-7.1; BT group mean 8.5, 95% CI: 7.1-9.9 and greater perception of change [PFMT 28 (73.6%); BT 12 (36.4%) (P=0.002)] after 5 months than the BT group.
  
  
  CONCLUSIONS
  High intensity PFMT is effective in managing stress urinary incontinence and is more effective than BT in healthy older women.
authors.affiliation: Rehabilitation Sciences Research Centre, Melbourne Physiotherapy School, The University of Melbourne, Parkville, Victoria, Australia. m.sherburn@unimelb.edu.au
authors.forename: Margaret
authors.initials: M
authors.lastname: Sherburn
authors.forename: Margaret
authors.initials: M
authors.lastname: Bird
authors.forename: Marcus
authors.initials: M
authors.lastname: Carey
authors.forename: Kari
authors.initials: K
authors.lastname: Bø
authors.forename: Mary P
authors.initials: MP
authors.lastname: Galea
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D010349:Patient Compliance; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities / Q000009:adverse effects; D011788:Quality of Life; D020127:Recovery of Function; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology*; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D014563:Urodynamics; D014739:Victoria