title: Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes.
abstract: BACKGROUND
  Residents 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.
  
  
  OBJECTIVE
  To 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.
  
  
  METHODS
  This 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.
  
  
  RESULTS
  Altogether, 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.
  
  
  CONCLUSIONS
  The 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.
authors.affiliation: Faculty of Nursing, Sør-Trøndelag University College, Trondheim, Norway. anne.g.vinsnes@hist.no
authors.forename: Anne G
authors.initials: AG
authors.lastname: Vinsnes
authors.forename: Jorunn L
authors.initials: JL
authors.lastname: Helbostad
authors.forename: Signe
authors.initials: S
authors.lastname: Nyrønning
authors.forename: Gene E
authors.initials: GE
authors.lastname: Harkless
authors.forename: Randi
authors.initials: R
authors.lastname: Granbo
authors.forename: Arnfinn
authors.initials: A
authors.lastname: Seim
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D009735:Nursing Homes; D017773:Pelvic Floor; D026741:Physical Therapy Modalities; D011788:Quality of Life; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000534:rehabilitation*