Researchers at Rush University Medical Center recently reported study results pointing to a new treatment approach to incontinence in elderly women. Urinary incontinence, or loss of bladder control, affects more than 13 million Americans and is twice as common in women as in men, affecting up to half of all older women. Often it is because the muscles that help support the bladder become weak, due to multiple vaginal births. "Urinary incontinence can take a very real emotional and social toll. Not knowing when and where you might have an accident can impact everything from household chores to dinner dates and bowling games," said physiatrist Dr. Sheila Dugan, co-director of the Program for Abdominal and Pelvic Health at Rush and lead author of the study. “Many treatment options exist, but strengthening the pelvic floor muscles, as our study has shown, can be very effective even for older women, avoiding the need for drugs or more invasive procedures." The study involved 65 women between the ages of 67 and 95; women in the treatment group underwent a supervised chair-based exercise program for six weeks. The program focused on identifying, isolating and strengthening three groups of muscles that support the pelvic area: the transversus abdominus that wraps around the abdomen; the multifidus located along the back of the trunk; and the pelvic floor muscles, which form a sling to hold up internal organs like the bladder. It also included a four-session educational curriculum on bladder and pelvic health. The control group received one session of educational basics and no supervised training in pelvic exercises. At the end of the program, 83 percent of the women in the treatment group had statistically significant improvements in a number of areas, whereas there were no statistically significant improvements for the control group. Problems with frequency of urination and urine leakage related to feelings of urgency and caused by physical activity, coughing or sneezing, all decreased. Bladder control problems were less bothersome and had less of an impact on daily activities; the women also reported less urgency during nighttime hours, better bladder management (especially when physically active or sneezing) and increased self-confidence. Eighty-two percent reported that they planned on continuing the exercise themselves after the intervention.
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