title: Physiotherapy and behavior therapy for the treatment of overactive bladder syndrome: a prospective cohort study.
abstract: OBJECTIVE
  To determine the efficacy of physiotherapy and behavior therapy and to find specific subgroups of women with overactive bladder syndrome that might gain increased benefit from this therapy.
  
  
  METHODS
  Women with ≥10 micturitions per 24-h period were included. Six to nine therapy sessions were held within a 14-day interval. Efficacy end point was a reduction in micturitions and in episodes of nocturia. Secondary outcomes included ICIQ-OAB, ICIQ-OABqol and visual analog scales. Follow-up was 6 months. Levene test, Student's t test, Pearson´s and Spearman's correlations were utilized as well as the Friedman test and a multivariable-multilevel model.
  
  
  RESULTS
  32 women were included. Mean age was 51 ± 15.9 (years ± standard deviation, sd). Mean body mass index (BMI) was 24.4 ± 4.8 (kg/m2± sd). There was a 22.9% reduction in the number of micturitions per 24 h (11.7 ± 1.6 vs. 9.0 ± 1.3 p < 0.001), a 21.3% reduction during the day (10.3 ± 1.4 vs. 8.1 ± 1.1 p < 0.001) and a 34.7% reduction in episodes of nocturia (1.5 ± 1.0 vs. 1.0 ± 0.8 p = 0.026). Both ICIQ-OAB (8.7 ± 2.3 vs. 5.8 ± 2.7 vs. 6.3 ± 3.3 p < 0.001) and ICIQ-OABqol (73.4 ± 25.9 vs. 47.5 ± 14.5 vs. 47.7 ± 18.6 p < 0.001) questionnaires as well as VAS (7.5 ± 1.4 vs. 4.1 ± 2.4 vs. 4.2 ± 2.7 p < 0.001) showed significant improvement persisting in the 6-month follow-up. In addition, in a multivariable model controlling for age, women who were overactive bladder syndrome therapy naïve responded significantly better than those who had already been under therapy (p < 0.001).
  
  
  CONCLUSIONS
  This study shows the efficacy of physiotherapy and behavior therapy in women with overactive bladder syndrome with a post-therapy effect especially for women with no prior treatment.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.
authors.forename: Martina
authors.initials: M
authors.lastname: Wolz-Beck
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.
authors.forename: Christl
authors.initials: C
authors.lastname: Reisenauer
authors.affiliation: Pelvic Floor Research Group, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Giselle E
authors.initials: GE
authors.lastname: Kolenic
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.
authors.forename: Sabine
authors.initials: S
authors.lastname: Hahn
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany.|Research Centre for Women's Health, University Hospital of Tuebingen, Tuebingen, Germany.
authors.forename: Sara Y
authors.initials: SY
authors.lastname: Brucker
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital of Tuebingen, Calwerstr. 7, 72074, Tuebingen, Germany. markus.huebner@med.uni-tuebingen.de.
authors.forename: Markus
authors.identifier: http://orcid.org/0000-0003-4906-7751
authors.initials: M
authors.lastname: Huebner
mesh_terms: D000328:Adult; D000368:Aged; D001521:Behavior Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000628:therapy*; D014554:Urination / Q000502:physiology; D064232:Visual Analog Scale
keywords: Alternative therapy; Behavior therapy; Overactive bladder syndrome; Physiotherapy; Quality of life