Iguchi S1, Inoue T1, Nojima I1, Sugiura H1
1Nagoya University Graduate School of Medicine, Department of Physical Therapy, Nagoya, Japan
Background: Urinary incontinence (UI) is highly prevalent in postmenopausal women, and substantially impacts quality of life. Previous studies have shown that women with pelvic organ prolapse have less lumbar lordosis or more thoracic kyphosis than women without pelvic organ prolapse. It is said that UI is bi-directionally related to pelvic organ prolapse while few studies have investigated the association between spinal posture and UI.
Purpose: The purpose of this study was to identify the relationship between UI and spinal curvature, and to compare spinal posture in accordance with the type of UI.
Methods: The participants comprised 76 postmenopausal women aged 59-87 years who underwent a comprehensive health investigation; those with a history of spinal disorder were excluded. The subjects were divided into those with UI (UI group) and those without UI (control group). UI was assessed using the International Consultation on Incontinence questionnaire-short form (ICIQ-SF). The UI group was further divided in accordance with UI type into the urge UI (UUI) group and the stress UI (SUI) group. Face-to-face interviews were performed to assess patient characteristics including age, number of deliveries, age at first childbirth, age at onset of menopause, and age at first menstruation. Spinal Mouse was used to assess spinal posture, including thoracic kyphosis angle, lumbar lordosis angle, and sacral inclination angle. The characteristics and spinal posture of the UI and control groups were compared using Mann-Whitney U tests. Spearman´s rank correlation coefficients were calculated for the total ICIQ-SF score, thoracic kyphosis, and lumbar lordosis angle.
Results: Thirty-two postmenopausal women (48%) had UI, while 44 were continent (52%). There were no significant differences in patient characteristics between the UI and control groups. Compared with the control group, the UI group had a significantly larger thoracic kyphosis angle (44.4 ± 11.2°versus 38.2 ± 9.4°; P 0.05), and a significantly smaller lumbar lordosis angle (-13.4 ± 12.2°versus -19.9 ± 8.7°; P 0.05). Furthermore, the total ICIQ-SF score was significantly positively associated with a larger thoracic kyphosis angle (r=0.25, P 0.05) and smaller lumbar lordosis angle (r=0.39, P 0.01). The lumbar lordosis was significantly smaller in the UUI group (-12.2 ± 9.0°) compared with the control group (P 0.05). The kyphosis angle in the SUI group (45.4 ± 9.6°) was significantly larger than that in the control group (P 0.05).
Conclusion(s): UI in community-dwelling postmenopausal Japanese women may be associated with greater thoracic kyphosis and lesser lumbar lordosis in standing position.
Implications: This is the first study to suggest that UI is associated with spinal posture in postmenopausal women in Japan. Improvement of UI may require changes in spinal posture.
Keywords: Urinary incontinence, spinal posture, postmenopausal women
Funding acknowledgements: This study was supported by grants for research received from Togo-town（61-J-0030）and Grants-in-Aid for Scientific Research-KAKENHI- (No. 17K17500).
Purpose: The purpose of this study was to identify the relationship between UI and spinal curvature, and to compare spinal posture in accordance with the type of UI.
Methods: The participants comprised 76 postmenopausal women aged 59-87 years who underwent a comprehensive health investigation; those with a history of spinal disorder were excluded. The subjects were divided into those with UI (UI group) and those without UI (control group). UI was assessed using the International Consultation on Incontinence questionnaire-short form (ICIQ-SF). The UI group was further divided in accordance with UI type into the urge UI (UUI) group and the stress UI (SUI) group. Face-to-face interviews were performed to assess patient characteristics including age, number of deliveries, age at first childbirth, age at onset of menopause, and age at first menstruation. Spinal Mouse was used to assess spinal posture, including thoracic kyphosis angle, lumbar lordosis angle, and sacral inclination angle. The characteristics and spinal posture of the UI and control groups were compared using Mann-Whitney U tests. Spearman´s rank correlation coefficients were calculated for the total ICIQ-SF score, thoracic kyphosis, and lumbar lordosis angle.
Results: Thirty-two postmenopausal women (48%) had UI, while 44 were continent (52%). There were no significant differences in patient characteristics between the UI and control groups. Compared with the control group, the UI group had a significantly larger thoracic kyphosis angle (44.4 ± 11.2°versus 38.2 ± 9.4°; P 0.05), and a significantly smaller lumbar lordosis angle (-13.4 ± 12.2°versus -19.9 ± 8.7°; P 0.05). Furthermore, the total ICIQ-SF score was significantly positively associated with a larger thoracic kyphosis angle (r=0.25, P 0.05) and smaller lumbar lordosis angle (r=0.39, P 0.01). The lumbar lordosis was significantly smaller in the UUI group (-12.2 ± 9.0°) compared with the control group (P 0.05). The kyphosis angle in the SUI group (45.4 ± 9.6°) was significantly larger than that in the control group (P 0.05).
Conclusion(s): UI in community-dwelling postmenopausal Japanese women may be associated with greater thoracic kyphosis and lesser lumbar lordosis in standing position.
Implications: This is the first study to suggest that UI is associated with spinal posture in postmenopausal women in Japan. Improvement of UI may require changes in spinal posture.
Keywords: Urinary incontinence, spinal posture, postmenopausal women
Funding acknowledgements: This study was supported by grants for research received from Togo-town（61-J-0030）and Grants-in-Aid for Scientific Research-KAKENHI- (No. 17K17500).
Topic: Women's & men's pelvic health; Musculoskeletal: spine; Older people
Ethics approval required: Yes
Institution: Nagoya university
Ethics committee: Health Sciences clinical and epidemiological research review committee
Ethics number: 2018-0038
All authors, affiliations and abstracts have been published as submitted.
