Canadian researchers have found that postmenopausal women with osteoporosis and urinary incontinence can get help for the latter problem via pelvic floor muscle training. The study, done by the BC Women’s Hospital & Health Centre in Vancouver, British Columbia, and the University of Montreal, Quebec, found that these exercises can produce major improvements for these patients. According to the February 17, 2016 news release, the study is the first-ever randomized, controlled trial of physical therapy for these urinary troubles in postmenopausal women with osteoporosis or low bone mass.
“The researchers recruited 48 women age 55 and older from an osteoporosis clinic and the waitlist for a continence clinic. All the women had gone through menopause and had incontinence and osteoporosis or low bone density. Incontinence included stress incontinence—leaking with activity that puts pressure on the bladder, such as coughing, laughing, or running, urge incontinence—leaking before reaching the toilet when there is a strong urge to urinate, or a mixture of the two types.”
“Half of the women went through 12 weekly sessions of physical therapy with a trained physical therapist. The therapy involved pelvic floor muscle exercise and retraining with biofeedback as well as other advice and techniques such as urge control and dietary changes. The other women had a three-hour education session on physical activity, diet, and medications used to prevent or treat osteoporosis, one-on-one sessions with a dietitian and physical therapist, and extensive follow-up discussions with healthcare providers. At the beginning of the study and after three months and one year, all of the women completed bladder diaries, incontinence and self-efficacy questionnaires, and pad tests, which measure how much urine leaks over 24 hours. The researchers who assessed patients’ progress or collected or analyzed the data did not know which patients got physical therapy and which got osteoporosis education.”
“Three months after the study began, the women who underwent physical therapy enjoyed a dramatic 75% reduction in urine leaks, whereas the other women did not improve. The physical therapy group also had significantly better results on the incontinence questionnaires. One year later, the women who got physical therapy still enjoyed the 75% reduction in leak episodes, whereas the other women got worse. The physical therapy group also had better pad test results and maintained better scores on one of the incontinence questionnaires.”
JoAnn V. Pinkerton, M.D., NCMP, is executive director of the North American Menopause Society. Dr. Pinkerton told OTW, “Orthopedic surgeons who are treating fractures in women as they age should consider whether or not the fracture might be due to osteoporosis that needs to be addressed after the fracture heals. And, if the osteoporotic fracture occurred after a fall, ask what led to the fall. If it was urgency incontinence (trying to get to the bathroom quickly), they might suggest pelvic floor therapy as well as physical therapy to heal the fracture. Treating the fracture is important, but preventing future fractures may be even more important.”
