What is the impact of a multi-component exercise intervention on the cure rate of urinary incontinence among older women living in the community?

Abstract

Aims

To determine the impact of a multi-component exercise intervention on the cure rate of urinary incontinence (UI) among older women living in the community.

Method

A systematic search was conducted of five databases (Medline, Cumulative Index to Nursing and Allied Health Literature [CINAHL], Academic Search Complete, PubMed and Web of Science), grey literature and reference lists of relevant studies in December 2021– January 2022 and again between January 2023 and February 2023 when no additional new studies were identified. Key inclusion criteria were studies with female older adults above the age of 60, with any type of UI, residing in the community, addressing the effects of a multi-component exercise intervention combining pelvic floor muscle training (PFMT), strength and balance exercises. The primary outcome of interest was the cure rate of UI in community-dwelling older women (%).

Studies underwent quality appraisal using the RevMan Risk of Bias tool and the Evidence-based Librarianship tool, identifying significant biases. A narrative synthesis presents results for all outcomes; a meta-analysis was also performed for secondary outcomes.

Results

Following the PRISMA 2020 guidelines, a total of 596 records were identified from the systematic search. Five studies met the inclusion criteria. Participants receiving the intervention had a statistically significant mean cure rate of 44.0% (p < 0.05), which decreased at follow-up, except for participants with stress UI. Participants receiving the intervention had significantly decreased frequency of UI episodes (p < 0.00001) and increased maximum walking speed (p < 0.0003) at a 3-month follow-up.

Conclusion

A multi-component exercise, combining PFMT, strength and balance exercises, is effective in improving and curing UI, especially stress UI, in community-dwelling older women.