Efficacy of a Therapeutic Pelvic Yoga Program Versus a Physical Conditioning Program on Urinary Incontinence in Women : A Randomized Trial.

IF 19.6 1区医学 Q1 MEDICINE, GENERAL & INTERNAL Annals of Internal Medicine Pub Date : 2024-08-27 DOI:10.7326/M23-3051

Alison J Huang, Margaret Chesney, Michael Schembri, Harini Raghunathan, Eric Vittinghoff, Wendy Berry Mendes, Sarah Pawlowsky, Leslee L Subak

{"title":"Efficacy of a Therapeutic Pelvic Yoga Program Versus a Physical Conditioning Program on Urinary Incontinence in Women : A Randomized Trial.","authors":"Alison J Huang, Margaret Chesney, Michael Schembri, Harini Raghunathan, Eric Vittinghoff, Wendy Berry Mendes, Sarah Pawlowsky, Leslee L Subak","doi":"10.7326/M23-3051","DOIUrl":null,"url":null,"abstract":"Background: Pelvic floor yoga has been recommended as a complementary treatment strategy for urinary incontinence (UI) in women, but evidence of its efficacy is lacking.Objective: To evaluate the effects of a therapeutic pelvic floor yoga program versus a nonspecific physical conditioning program on UI in women.Design: Randomized trial. (ClinicalTrials.gov: NCT03672461).Setting: Three study sites in California, United States.Participants: Ambulatory women aged 45 years or older reporting daily urgency-, stress-, or mixed-type UI.Intervention: Twelve-week program of twice-weekly group instruction and once-weekly self-directed practice of pelvic floor-specific Hatha yoga techniques (pelvic yoga) versus equivalent-time instruction and practice of general skeletal muscle stretching and strengthening exercises (physical conditioning).Measurements: Total and type-specific UI frequency assessed by 3-day voiding diaries.Results: Among the 240 randomly assigned women (age range, 45 to 90 years), mean baseline UI frequency was 3.4 episodes per day (SD, 2.2), including 1.9 urgency-type episodes per day (SD, 1.9) and 1.4 stress-type episodes per day (SD, 1.7). Over a 12-week time period, total UI frequency (primary outcome) decreased by an average of 2.3 episodes per day with pelvic yoga and 1.9 episodes per day with physical conditioning (between-group difference of -0.3 episodes per day [95% CI, -0.7 to 0.0]). Urgency-type UI frequency decreased by 1.2 episodes per day in the pelvic yoga group and 1.0 episode per day in the physical conditioning group (between-group difference of -0.3 episodes per day [CI, -0.5 to 0.0]). Reductions in stress-type UI frequency did not differ between groups (-0.1 episodes per day [CI, -0.3 to 0.3]).Limitation: No comparison to no treatment or other clinical UI treatments; conversion to videoconference-based intervention instruction during the COVID-19 pandemic.Conclusion: A 12-week pelvic yoga program was not superior to a general muscle stretching and strengthening program in reducing clinically important UI in midlife and older women with daily UI.Primary funding source: National Institutes of Health.","PeriodicalId":7932,"journal":{"name":"Annals of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":19.6000,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Internal Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.7326/M23-3051","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Pelvic floor yoga has been recommended as a complementary treatment strategy for urinary incontinence (UI) in women, but evidence of its efficacy is lacking.

Objective: To evaluate the effects of a therapeutic pelvic floor yoga program versus a nonspecific physical conditioning program on UI in women.

Design: Randomized trial. (ClinicalTrials.gov: NCT03672461).

Setting: Three study sites in California, United States.

Participants: Ambulatory women aged 45 years or older reporting daily urgency-, stress-, or mixed-type UI.

Intervention: Twelve-week program of twice-weekly group instruction and once-weekly self-directed practice of pelvic floor-specific Hatha yoga techniques (pelvic yoga) versus equivalent-time instruction and practice of general skeletal muscle stretching and strengthening exercises (physical conditioning).

Measurements: Total and type-specific UI frequency assessed by 3-day voiding diaries.

Results: Among the 240 randomly assigned women (age range, 45 to 90 years), mean baseline UI frequency was 3.4 episodes per day (SD, 2.2), including 1.9 urgency-type episodes per day (SD, 1.9) and 1.4 stress-type episodes per day (SD, 1.7). Over a 12-week time period, total UI frequency (primary outcome) decreased by an average of 2.3 episodes per day with pelvic yoga and 1.9 episodes per day with physical conditioning (between-group difference of -0.3 episodes per day [95% CI, -0.7 to 0.0]). Urgency-type UI frequency decreased by 1.2 episodes per day in the pelvic yoga group and 1.0 episode per day in the physical conditioning group (between-group difference of -0.3 episodes per day [CI, -0.5 to 0.0]). Reductions in stress-type UI frequency did not differ between groups (-0.1 episodes per day [CI, -0.3 to 0.3]).

Limitation: No comparison to no treatment or other clinical UI treatments; conversion to videoconference-based intervention instruction during the COVID-19 pandemic.

Conclusion: A 12-week pelvic yoga program was not superior to a general muscle stretching and strengthening program in reducing clinically important UI in midlife and older women with daily UI.

Primary funding source: National Institutes of Health.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

骨盆瑜伽治疗计划与体能训练计划对女性尿失禁的疗效：随机试验。

背景：盆底瑜伽已被推荐为女性尿失禁（UI）的辅助治疗策略，但其疗效尚缺乏证据：目的：评估治疗性盆底瑜伽项目与非特异性身体调节项目对女性尿失禁的影响：设计：随机试验。(设计：随机试验（ClinicalTrials.gov：NCT03672461）：研究地点：美国加利福尼亚州的三个研究地点：干预措施：干预措施：为期 12 周的计划，每周两次小组指导，每周一次自我指导，练习针对骨盆底的哈达瑜伽技巧（骨盆瑜伽）与同等时间的一般骨骼肌拉伸和强化练习（身体调节）：测量：通过 3 天排尿日记评估总的和特定类型的尿失禁频率：结果：在随机分配的 240 名妇女（年龄在 45 岁至 90 岁之间）中，平均基线尿失禁频率为每天 3.4 次（SD，2.2），其中急迫型每天 1.9 次（SD，1.9），压力型每天 1.4 次（SD，1.7）。在为期 12 周的时间里，骨盆瑜伽和体能训练的尿频总次数（主要结果）分别平均每天减少 2.3 次和 1.9 次（组间差异为每天-0.3 次[95% CI，-0.7 至 0.0]）。骨盆瑜伽组急迫型尿失禁频率每天减少 1.2 次，体能调节组每天减少 1.0 次（组间差异为每天-0.3 次[CI，-0.5 至 0.0]）。压力型尿失禁频率的降低在组间无差异（每天-0.1次[CI，-0.3至0.3]）：局限性：未与无治疗或其他临床尿失禁治疗进行比较；在COVID-19大流行期间转为基于视频会议的干预指导：结论：为期 12 周的骨盆瑜伽计划在减少中老年女性日常尿失禁的临床重要尿失禁症状方面，并不优于一般的肌肉拉伸和强化计划：主要资金来源：美国国立卫生研究院。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Annals of Internal Medicine 医学-医学：内科

CiteScore

23.90

自引率

1.80%

发文量

1136

审稿时长

3-8 weeks

期刊介绍： Established in 1927 by the American College of Physicians (ACP), Annals of Internal Medicine is the premier internal medicine journal. Annals of Internal Medicine’s mission is to promote excellence in medicine, enable physicians and other health care professionals to be well informed members of the medical community and society, advance standards in the conduct and reporting of medical research, and contribute to improving the health of people worldwide. To achieve this mission, the journal publishes a wide variety of original research, review articles, practice guidelines, and commentary relevant to clinical practice, health care delivery, public health, health care policy, medical education, ethics, and research methodology. In addition, the journal publishes personal narratives that convey the feeling and the art of medicine.