title: Physical therapy for urinary incontinence in postmenopausal women with osteoporosis or low bone density: a randomized controlled trial.
abstract: 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.
authors.affiliation: 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.
authors.forename: Meena
authors.initials: M
authors.lastname: Sran
authors.forename: Joanie
authors.initials: J
authors.lastname: Mercier
authors.forename: Penny
authors.initials: P
authors.lastname: Wilson
authors.forename: Pat
authors.initials: P
authors.lastname: Lieblich
authors.forename: Chantale
authors.initials: C
authors.lastname: Dumoulin
mesh_terms: D000368:Aged; D015519:Bone Density; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D008875:Middle Aged; D015663:Osteoporosis, Postmenopausal / Q000150:complications*; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000150:complications / Q000628:therapy*