Effectiveness of a Urinary Continence Physiotherapy Program (UCPP) for Chinese elderly women in a community setting

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Effectiveness of a Urinary Continence Physiotherapy Program (UCPP) for Chinese elderly women in a community setting


Author: Leong, Bik-sai
Title: Effectiveness of a Urinary Continence Physiotherapy Program (UCPP) for Chinese elderly women in a community setting
Degree: M.Sc.
Year: 2008
Subject: Hong Kong Polytechnic University -- Dissertations.
Urinary incontinence -- Physical therapy.
Urinary incontinence in old age -- China -- Hong Kong.
Older women -- Health and hygiene -- China -- Hong Kong.
Department: Dept. of Rehabilitation Sciences
Pages: xiv, 102 leaves : ill. (some col.) ; 30 cm.
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b2232408
URI: http://theses.lib.polyu.edu.hk/handle/200/5158
Abstract: Background: Urinary incontinence (UI) is a prevalent condition in elderly women globally. It can seriously degrade the quality of life for many active senior and negatively impact their well-being. It is also a social stigma leading to loss of independence and a significant source of social financial burden for healthcare services. In Hong Kong, the reported prevalence rate of UI ranges from 13% to 40.8%. Despite the extensive literatures on conservative management of urinary incontinence, it is not know whether a structural combination exercise therapy is feasible and effective for elderly women with stress (SUI), urge (UUI) or mixed urinary incontinence (MUI). Besides, there are no randomized controlled studies which examined the effect of Pelvic Floor Muscle Exercise (PFME) or Bladder Training (BT) for management of UI in Hong Kong. Method: This was a randomized control trial with two-group pretest-posttest design. A total of 55 elderly women with mild to moderate severity of UI, were recruited by convenience sampling from 6 of 18 Elderly Health Centres (EHCs), Department of Health, Hong Kong. They were randomly assigned to either a treatment or control group. The subjects in the treatment group received a 12-week Urinary Continence Physiotherapy Program (UCPP), whereas an educational pamphlet on management of UI including the basic information about UI, self management tips and description of PFME, was given to the subjects in the control (no active treatment) group. The primary outcome variable was the number of UI episodes per 7 days (UI7). Secondary outcome variables included participants' perception of improvement, condition-specific impact on quality of life (Incontinence Impact Questionnaire -Chinese version) treatment satisfaction and program compliance. Result: The mean age of all subjects was 74.25 +- 4.59 years. There was a significant reduction of UI7 in the treatment group at the end of the treatment program. The mean of the UI7 for treatment and control group were 1.00 +- 1.88 and 7.43 +- 6.19 respectively at 12 weeks. There was no significant interaction between weeks and "Type of incontinence" (F(2,25)=0.92, p=0.51), indicating that the three different types of incontinence (SUI, UUI, MUI) showed similar improvement in UI7. The result also showed that there was significant difference in the subjective perception of improvement between both groups (t=33.89, p<0.001) with a mean difference of 7.28. The perception of improvement in the treatment group was 8.70 +- 0.92 compared to 1.42 +- 0.65 in the control group at week 12, when measured with a 10-point VAS scale. The mean of treatment satisfaction, mean attendance and exercise adherence rate of treatment group were good. The mean of treatment satisfaction was 9.52 +- 0.74 as measured in a 10-point VAS scale. The mean attendance and exercise adherence rate were 97.69 +- 4.95(%) and 99.36 +- 1.90(%) respectively. There was no drop out in the study. Conclusion: This study demonstrated that UCPP was equally effective for stress, urge and mixed incontinence. Reported benefits of the treatment group in this study also include the significant improvement of their quality of life (as measured by IIQ-Chinese version), high level of satisfaction with their progress (treatment satisfaction and compliance) and no adverse effects reported. Treatment protocol was also viewed favourably by clients including the frequency, intensity and duration of the treatment period and the exercises can be performed conveniently in their daily living. This study was specific to the treatment of mild to moderate SUI, UUI and MUI in Chinese elderly women.

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