title: Defeating Urinary Incontinence with Exercise Training: Results of a Pilot Study in Frail Older Women.
abstract: OBJECTIVE
  To determine whether combining behavioral urinary incontinence (UI) treatments with physical activity improves UI in frail older women.
  
  
  METHODS
  Single-blind, two-arm pilot randomized controlled trial.
  
  
  METHODS
  Senior apartments.
  
  
  METHODS
  Frail women (mean age 84.9 ± 6.4) without dementia (n = 42).
  
  
  METHODS
  Twelve-week program of customized behavioral UI treatments: 150 minutes of weekly walking and twice weekly strength training classes.
  
  
  METHODS
  UI was measured using 3-day bladder diaries, the International Consultation on Incontinence Questionnaire (ICIQ), and UI global improvement questions. Toileting skills were measured using the Performance Oriented Timed Toileting Instrument (POTTI) and the Minnesota Toileting Skills Questionnaire (MTSQ). Physical function was measured using the Short Physical Performance Battery. UI-related quality of life was measured using the Incontinence Impact Questionnaire and Urogenital Distress Inventory.
  
  
  RESULTS
  The treatment group reported a 50% reduction in daily leaks using bladder diaries, and the control group reported no change (P = .04). Although there were no group differences in total ICIQ scores (P = .66), the treatment group reported significantly greater improvement on the ICIQ item for urine leakage (P = .01). More than 81% of the treatment group and 36% of the control group reported improvement in UI (χ2= 4.84, P = .01), with mean estimated percentage improvement of 65.3 ± 32.0 versus 34.1 ± 41.3 (P = .03). Although the difference was not statistically significant, treatment group participants improved their toileting skills, whereas those of the control group declined (P = .42 POTTI, P = .11 MTSQ). Balance (P = .33) and gait (P = .24) improved more in the treatment group, whereas chair stands improved more in the control group (P = .14).
  
  
  CONCLUSIONS
  UI may be improved in frail older women by combining behavioral strategies for UI with physical activity, but larger trails are needed to determine whether these findings can be replicated and sustained.
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Kristine M C
authors.initials: KMC
authors.lastname: Talley
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Jean F
authors.initials: JF
authors.lastname: Wyman
authors.affiliation: College of Nursing, University of Illinois at Chicago, Chicago, Illinois.
authors.forename: Ulf
authors.initials: U
authors.lastname: Bronas
authors.affiliation: Department of Rehabilitation Medicine, Division of Physical Therapy, University of Minnesota, Minneapolis, MN.
authors.forename: Becky J
authors.initials: BJ
authors.lastname: Olson-Kellogg
authors.affiliation: Department of Family Medicine and Community Health, University of Minnesota, Minneapolis, Minnesota.
authors.forename: Teresa C
authors.initials: TC
authors.lastname: McCarthy
mesh_terms: D000369:Aged, 80 and over; D001521:Behavior Therapy / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D016330:Frail Elderly / Q000523:psychology*; D006801:Humans; D008910:Minnesota; D010865:Pilot Projects; D011788:Quality of Life; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000503:physiopathology / Q000534:rehabilitation*
keywords: frail; intervention; older women; randomized controlled trial; urinary incontinence