Abstract
Background: Urinary incontinence as a target for fall risk reduction has not been extensively studied.
Objective: To assess the effectiveness of a focused evidence-based physical therapy intervention for urinary incontinence in older women on reducing fear of falling.
Design: A multiple-baseline, quasiexperimental, single-group, pre-/postpilot study spanning 8 weeks, with a 1-month follow-up.
Methods: Twenty women 50 years and older with urge or mixed (ie, urge and stress) incontinence and a score of 20 or more on the Falls Efficacy Scale-International (FES-I) were recruited from 2 outpatient pelvic health clinics associated with a university health system in the southwestern United States. Physical therapy consisted primarily of a standardized program of progressive pelvic floor strengthening exercises. Questionnaires and physical performance measures were administered at baseline 1; at the start of physical therapy (baseline 2); midpoint of therapy; and at discharge. The FES-I was administered by phone at a 1-month follow-up.
Results: There were statistically significant improvements from baseline for the FES-I (P = .02), the Incontinence Impact Questionnaire-7 (IIQ-7) (P < .01), and a measure of Life Satisfaction (P = .01). Most of the improvement in the primary outcomes (FES-I and IIQ-7) occurred in the first 4 weeks of therapy. Changes in the FES-I and the IIQ-7 followed a similar trajectory.
Conclusions: Findings suggest that physical therapy interventions for incontinence in older women may be an important treatment option for also addressing fear of falling.
This article has a Video Abstract at http://links.lww.com/JWHPT/A20.