Low-impact yoga and exercise found to help older women manage urinary incontinence

Older women battling urinary incontinence can profit from common, low-impact exercise, with yoga in addition to stretching and strengthening displaying advantages in a brand new study revealed Aug. 27 in Annals of Internal Medicine.

The analysis, led by scientists at Stanford Medicine and the University of California, San Francisco, is a part of a larger effort to establish low-risk, low-cost methods to deal with probably the most widespread well being issues women face as they age.

After 12 weeks of a low-impact yoga program, research individuals had about 65% fewer episodes of incontinence. Women in a management group doing stretching and strengthening workout routines skilled an identical profit over the identical time interval. The advantages are on par with the results of medicines used to handle incontinence, the researchers mentioned.

“Our study was testing the kind of yoga that just about anyone can do, with modifications for different physical abilities,” mentioned the research’s senior creator, Leslee Subak, MD, chair of obstetrics and gynecology at Stanford Medicine. “What I love about it is that it’s safe, inexpensive, doesn’t require a doctor and accessible wherever you live.” Because the trial was performed partly throughout the COVID-19 pandemic, many individuals acquired their yoga or exercise instruction by way of on-line conferences, exercising in their very own houses, she famous.

The research’s lead creator is Alison Huang, MD, professor of drugs, urology, and epidemiology and biostatistics at UCSF.

Urinary incontinence, which impacts greater than half of middle-aged women and up to 80% of 80-year-olds, can lead to a wide range of different issues, from social isolation to bone fractures brought on by falls. But there’s help.

“Part of the problem is that incontinence is stigmatized; we don’t talk about it,” mentioned Subak, the Katharine Dexter McCormick and Stanley McCormick Memorial Professor III. “Or we hear folklore about this being normal when you get older. In fact, it’s very common but it’s not inevitable, and we have very effective ways of treating it.”

Addressing a typical downside

Incontinence deserves good therapy due to the various methods it interferes with individuals’s lives.

“It takes away independence,” Subak mentioned. “My patients will say, ‘I can’t stay with my kids or grandkids because I’m afraid I’ll wet the bed, and I can’t talk about it; it’s too embarrassing.'”

Patients might keep away from actions that would enhance their well-being, resembling exercising and seeing mates. They are extra probably to be admitted to a nursing residence and to endure sure severe medical issues resembling hip fractures.

“Incontinence and overactive bladder are among the many greatest danger components for falls and fractures amongst older women,” Subak mentioned. “You’re rushing to the bathroom at night—with the lights off—tripping and falling, and breaking a hip.”

Some components that contribute to danger for incontinence cannot be modified, resembling ageing or having had kids. But others are modifiable.

“Quite a lot of my analysis has centered on weight reduction and physical activity, which actually are efficient remedies,” Subak mentioned. She turned focused on learning yoga as a therapy after a few of her sufferers instructed her it helped them.

Being lively helps

The research in contrast two 12-week exercise applications: 121 individuals had been randomly assigned to yoga, and 119 to a bodily conditioning management group. The individuals had been women with urinary incontinence that precipitated signs no less than as soon as a day. They had been 45 to 90 years outdated, with a imply age of 62.

In the yoga program, individuals realized 16 hatha yoga poses meant to strengthen the pelvic ground, by way of two 90-minute periods per week. The pelvic ground consists of the muscle tissue that type the bottom of the pelvis and maintain its organs—together with the bladder and urethra—in place. Participants had been additionally requested to apply yoga for no less than one hour per week exterior of sophistication and to keep a apply log.

Participants within the management group spent an equal period of time in exercise courses, however their courses centered on nonspecific stretching and strengthening workout routines that didn’t interact the pelvic floor. They had been additionally requested to apply for an extra hour per week and hold a apply log.

The research started with in-person courses, then transitioned to a videoconference format when the COVID-19 pandemic lockdowns started.

Participants recorded once they leaked urine and categorised whether or not every episode was urgency incontinence, when an overactive bladder causes an individual to really feel the necessity to urinate extra usually than traditional, or stress incontinence, in response to stress within the stomach, resembling from coughing or sneezing. They additionally answered commonplace questionnaires about their bladder perform.

At the start of the research, the individuals had a median of three.4 episodes of urinary incontinence per day, together with 1.9 urgency-type episodes and 1.4 stress-type episodes.

By the top of the 12-week applications, individuals within the yoga group had been experiencing 2.3 fewer episodes of incontinence per day, on common. Those within the bodily conditioning group had been experiencing 1.9 fewer episodes per day.

The two remedies are about equally efficient, with each approaches decreasing episodes of incontinence by round 60%, and the advantages from each remedies are significant, Subak mentioned. Patients who would love to attempt these approaches can seek for low-impact Iyengar yoga or low-impact exercise courses of their communities or on-line, she mentioned, including that instructors ought to have the opportunity to adapt the exercise to individuals’ bodily limitations.

“I’m impressed that exercise did so well and impressed that yoga did so well,” Subak mentioned. “One of the take-home messages from this study is ‘Be active!'”

Other nonsurgical remedies for incontinence, together with medicines, sometimes lead to a 30% to 70% enchancment in signs, she famous.

If a affected person requested whether or not yoga might help with incontinence, “I would say that I think it’s a great idea to try it if you’re interested,” Subak mentioned. “It’s very low danger, and there’s potential for profit not just for incontinence but additionally to your basic well-being.”