title: Self-induced plantar-flexion objectively reduces wave amplitude of detrusor overactivity and subjectively improve urinary urgency: a pilot study.
abstract: OBJECTIVE
  To estimate the effect of plantar-flexion on the wave amplitude of involuntary detrusor contraction and the severity of urinary urgency during filling cystometry in patients with detrusor overactivity (DO).
  
  
  METHODS
  Twenty-two consecutive patients with DO were enrolled. During urodynamics, the mean peak detrusor pressures of each contraction were documented and compared. At the beginning of the 2nd or 3rd wave, patients were asked to perform continuous plantar-flexion by pushing their tiptoes against the floor. Following each wave, patients were asked to grade the severity of the urgency by a visual analogue scale (VAS).
  
  
  RESULTS
  The mean peak detrusor pressure without plantar-flexion was 58 cmH2 O (95% CI: 46.3-69.7) compared to 31 cmH2 O (95% CI: 23.1-38.9) with plantar-flexion (P < 0.001). All patients reported a reduced degree of urgency during plantar-flexion reflected in a significant reduction in mean VAS score from 9.3 (95% CI: 9-9.5) to 4.7 (95% CI: 3.9-5.4; P < 0.0001).
  
  
  CONCLUSIONS
  Self-performed plantar-flexion maneuver might reduce the severity of urinary urgency and the magnitude of overactive detrusor contractions, which may have a role in the conservative therapy of detrusor overactivity.
authors.affiliation: Neurourology Division, Department of Urology, Assaf Harofeh Medical Center, Beer Yaakov, Zerifin, Tel Aviv, Israel; Affiliated to Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Kobi
authors.initials: K
authors.lastname: Stav
authors.forename: Dan
authors.initials: D
authors.lastname: Leibovici
authors.forename: Siegel I
authors.initials: SI
authors.lastname: Yoram
authors.forename: Ohlgisser
authors.initials: O
authors.lastname: Ronny
authors.forename: Amnon
authors.initials: A
authors.lastname: Zisman
mesh_terms: D000368:Aged; D059026:Diagnostic Self Evaluation; D055724:Electrophysiological Phenomena; D005260:Female; D005528:Foot / Q000502:physiology; D006801:Humans; D008297:Male; D009119:Muscle Contraction; D009130:Muscle, Smooth / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D012720:Severity of Illness Index; D001743:Urinary Bladder / Q000503:physiopathology*; D053201:Urinary Bladder, Overactive / Q000503:physiopathology* / Q000628:therapy
keywords: detrusor overactivity; overactive bladder; plantar flexion; urinary incontinence; urinary urgency