Document Detail


Behavioral therapy to treat urinary incontinence in Parkinson disease.
MedLine Citation:
PMID:  21555729     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the feasibility and efficacy of exercise-based behavioral therapy to treat urinary incontinence (UI) in older adults with Parkinson disease (PD).
METHODS: Participants with PD ≥50 years with ≥4 UI episodes on a 7-day bladder diary were recruited from movement disorders clinics. In 5 visits over 8 weeks, participants learned pelvic floor muscle exercises using computer-assisted EMG biofeedback, and bladder control strategies including urge suppression. Bladder diaries were used to reinforce techniques and monitor the primary outcome of UI frequency. Secondary outcomes included additional reporting of lower urinary tract symptoms, symptom bother, and quality of life (QOL) using the International Consultation on Incontinence Questionnaire for overactive bladder (ICIQ-OAB).
RESULTS: Twenty participants were enrolled (90% male, age 66.5 ± 6.2 [mean ± SD], with PD for 6.9 ± 5.4 years) and 17 completed the study. The median (interquartile range) weekly frequency of baseline UI episodes was 9 (4-11) and following intervention was 1 (0-3), representing an 83.3% reduction (45.5-100.0, p = 0.0001). QOL scores on the ICIQ-OAB improved from 71.1 ± 23.9 to 54.7 ± 15.4 (p = 0.002).
CONCLUSIONS: In this uncontrolled pilot study of an exercise-based, biofeedback-assisted behavioral intervention, older participants with PD demonstrated statistically significant and clinically meaningful reductions in frequency of UI and improvement in QOL. Randomized controlled trials to assess behavioral therapies for UI in patients with PD are warranted.
CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that exercise-based, biofeedback-assisted behavioral intervention can reduce UI frequency in patients >50 years old with PD.
Authors:
C P Vaughan; J L Juncos; K L Burgio; P S Goode; R A Wolf; T M Johnson
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  Neurology     Volume:  76     ISSN:  1526-632X     ISO Abbreviation:  Neurology     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-10     Completed Date:  2011-07-11     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  0401060     Medline TA:  Neurology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1631-4     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Behavior Therapy / methods*
Diagnosis, Computer-Assisted / methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Neurofeedback / methods
Outcome Assessment (Health Care)
Parkinson Disease / complications
Quality of Life
Questionnaires
Time Factors
Urinary Incontinence / etiology,  therapy*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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