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Rehabilitation combined with dietary intervention improve urinary incontinence in women with obesity: a proof-of-principle study
Capodaglio P, Lippi L, Folli A, Trotti G, Aspesi V, Turco A, de Sire A, Invernizzi M
Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi [Turkish Journal of Physical Medicine and Rehabilitation] 2024;70(1):39-46
clinical trial
7/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVES: This study aimed to assess the impact of add-on pelvic floor exercises on a weight management rehabilitation program. PATIENTD ANF METHODS: This proof of principle study was conducted between July 2019 and December 2019. Ninety-three adult female inpatients with obesity and diagnosis of urinary incontinence (UI) were assessed for inclusion, and the suitable patients were randomly assigned to the experimental group and the control group. Both groups underwent a weight management rehabilitation program, while the experimental group also performed pelvic floor exercises. The primary outcome was UI severity, assessed by the 1-h pad test. Secondary outcomes were urinary symptoms, assessed by the International Consultation on Incontinence Questionnaire Short Form (ICIQ-SF), Patient Global Impression of Improvement (PGI-I), and Incontinence Quality of Life Questionnaire (I-QOL). RESULTS: Sixty female inpatients were randomly assigned to the experimental group (n = 30; median age 64.50 (51.25 to 70.50) years) or the control group (n = 30; median age 67.50 (58.50 to 74.75) years). The experimental group showed a statistically significant reduction in UI severity (pad test 2.08 (1.21 to 8.85) g versus 0.54 (0.24 to 1.13) g, p < 0.01; ICIQ-SF 14.00 (10.25 to 17.00) versus 8.00 (6.25 to 11.75), p < 0.01; I-QOL 56.37 (42.28 to 73.64) versus 78.64 (64.32 to 90.68), p < 0.01). Statistically significant differences were found in the between-groups analysis (pad test 0.54 (0.24 to 1.13) g versus 1.08 (0.83 to 3.86) g, p < 0.01; ICIQ-SF 8.00 (6.25 to 11.75) versus 12.00 (10.00 to 16.00), p < 0.01; I-QOL 78.64 (64.32 to 90.68) versus 68.18 (60.00 to 84.32), p < 0.01). CONCLUSION: Including pelvic floor exercises might provide additional benefits compared to standard rehabilitation in reducing UI symptoms in obese women.

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