To evaluate the effectiveness of a community-based PFE program compared to drug management in reducing symptoms and enhancing the quality of life in elderly women with SUI.
This double-blinded, two-arm randomized controlled trial compared the effectiveness of a community-based pelvic floor muscle exercise program versus drug management in elderly women with stress urinary incontinence. Conducted from July to December 2023, 60 women aged 55 and above.
Participants were recruited through a population-based survey and enrolled via simple random sampling. The pelvic floor muscle exercise group received 30-minutes per session. The session was 2 time per week sessions for 12 weeks focusing on pelvic floor exercises, followed with home exercises. Patient did their home exercise under guidance by Physiotherapist and had to evaluate the procedure. The drug management group was prescribed Duloxetine Hydrochloride, starting at 30 mg/day and increasing to 60 mg/day.
Outcomes, including symptom reduction and quality of life, were assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) and Questionnaire for Urinary Incontinence Diagnosis (QUID) questionnaires, with muscle performance measured by pressure biofeedback. Data were analysed using SPSS version 20.0, with t-tests and Mann-Whitney U tests for group comparisons, at a significance level of p 0.05.
Results indicate that the drug management group had higher mean ranks than the PFME group for the QUID stress scores (35.37 vs. 25.63), suggesting that the medication group may have experienced more stress-related symptoms. ICIQ-UI score which assesses frequency, severity, and quality of life, the PFME group had a higher mean rank (35.98 vs. 25.02), indicating better outcomes in terms of urinary incontinence.
In terms of significance, since the p-value is less than 0.05 for both QUID and ICIQ-UI, both results are statistically significant. However, the group with the higher mean rank indicates more pronounced effects for that specific outcome. For QUID, drug management group shows more stress, while PFME shows better outcomes in ICIQ-UI.
Additionally, the pelvic floor muscle group demonstrated superior pelvic floor muscle activation (mean rank 27.90 vs. 20.60) and endurance (mean rank 31.50 vs. 18.50) compared to the medication, with p0.05, which indicates, improved muscle performance through pressure biofeedback than medication group.
This study shows that the pelvic floor muscle exercise program is an effective intervention compared to medication management in reducing symptoms and improving the quality of life in elderly women suffering from SUI.
This underscores the need to integrate pelvic floor muscle exercises into physiotherapy practices and emphasizes its importance in training and patient education. Furthermore, Healthcare policy should prioritize non-pharmacological interventions like pelvic floor muscle exercises over medication for managing incontinence in older adults.
Pelvic Floor Muscles Exercise
Drug Management
