| Summary: | 碩士 === 國立陽明大學 === 物理治療暨輔助科技學系 === 98 === Background and Objective: Urinary incontinence (UI) is a common chronic condition that affects people of all ages. Traditional treatments for UI include surgery, pharmacotherapy, and behavioral interventions. Nevertheless, few studies have reported the effects of group-based Pilates or functional fitness exercise training on stress UI (SUI) in community-dwelling women. This study aimed to compare the effects of Pilates-dominated versus fitness-dominated exercise training in reducing urine leakage and improving physical fitness for women with SUI.
Methods: This is a quasi-experimental study, recruiting 47 women with SUI who were older than 40 y/o and had urine leakage episode≧1 time/month. The measurements included: 1) Basic history taking; 2) UI severity status, overall subjective satisfaction & health-related quality of life (HR-QoL), and 3) Physical fitness. Two intervention groups, “Pilates-dominated” & “fitness-dominated” exercise training, aimed at improving UI status and enhancing fitness with 15 minutes education and 50 minutes exercise per session, once to twice per week were conducted lasting for 12 weeks.
Results: After 12 weeks training, 57% of “Pilates-dominated” group and 88% of “fitness-dominated” group obtained adequate urinary control (no urine leakage or less than once a month). Both groups improved significantly on UI severity status in terms of bladder diary (P<.01) and incontinence severity index (P<.001), as well as King’s HR-QoL questionnaire (P<.05) and overall satisfaction (scored 4.6-4.9 in average). The “Pilates-dominated” group demonstrated greater improvement in urinary control and HR-QoL; while the “fitness-dominated” group improved better in physical fitness, especially upper/lower limb muscular endurance. Favorable body composition changes including increased muscle mass, decreased fat percentage and increased symmetry of left / right muscle ratio (100%) were observed in both groups. Adequate urinary control was found to be related to baseline incontinence severity, and change of waist circumference.
Conclusions and Recommendations: Through small-group based, gymnasium-like exercise model, both 12-week “Pilates-dominated” and “fitness-dominated” exercise training could improve urinary incontinence, physical fitness and HR-QoL for women with SUI. Pilates group showed better effects in improving urinary incontinence symptoms and HR-QoL than the fitness group; possibly due to its task-specific nature focusing on improving pelvic floor control along with high exercise adherence of subjects. Fitness group might have demonstrated its expected effects by adding measurements of cardio-respiratory fitness or urinary control during high-level physical activities. This study opened room for more multi-dimensional or creative exercise programs to be implemented in the community to benefit more women suffering from SUI.
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