A comparative effectiveness study of overactive bladder (OAB) treatment using a pelvic floor fitness program for senior women

Introduction: This study compared the efficacy of a chair-based pelvic fitness/educational to an educational-only program for women with OAB in residential living facilities. The pelvic fitness/educational program was adapted from an evidence-based all-ages program to improve OAB symptoms. Methods: Following IRB approval, women (>65 years) with OAB were assigned (4 treatment:1 control) to twice weekly chair-based program (9-15 women each) for 6 weeks vs an education-only. Pre/post assessments included Visual Analog Scale (VAS) measuring symptom severity, Urinary Distress Inventory (UDI-6), Incontinence Impact Questionnaire (IIQ-7), and Timed Up & Go Test (TUG). Results: Fifty-seven of 65 enrollees completed the study: 43 fitness:14 control. Mean age was 83 years (67-95), 96% were Caucasian; 84% had a prior pregnancy (median vaginal parity 3). No significant between-group demographic differences existed. Baseline OAB symptoms were similar in treatment vs control: moderately/greatly bothered by leakage related to urgency (49% vs. 38%), frequency (67% vs. 46%) and urge incontinence (27% vs. 25%). Baseline IIQ and UDI-6 scores were similar (6.5 vs.4.5; 1.0 vs 1.0, respectively). Post-study, 91% were satisfied, 83% reported urinary symptom improvement and 2/3rds achieved pre-study goals. More women in the chair-based program reported symptom improvement ( IIQ-7, p=<.0001; UDI-6 scores p=.0036). Statistically significant changes were seen in mobility (TUG, p=.0129). Several reported less night urgency, better bladder management, better posture and awareness of bladder-related health and nutrition. No adverse events occurred. Conclusions: Pelvic fitness/educational programs are promising approaches for OAB symptom reduction, activity-level improvement and overall quality-of-life for women over 65.