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Jo Booth, Dawn Skelton, Carolyn MacInnes, Claire Ballinger, Tracey Howe. The effects of lifestyle and behavioural interventions for urinary incontinence on mobility, physical activity and falls in older people. Urinary symptoms.

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Jo booth dawn skelton carolyn macinnes claire ballinger tracey howe

Jo Booth, Dawn Skelton, Carolyn MacInnes, Claire Ballinger, Tracey Howe

The effects of lifestyle and behavioural interventions for urinary incontinence on mobility, physical activity

and falls in older people


Urinary symptoms
Urinary symptoms

  • Urinary incontinence (UI) and other lower urinary tract symptoms (LUTS) are common in older people and prevalence increases with age

  • Storage symptoms Voiding symptoms

    Frequency 68% Weak stream 43%

    Urgency 53% Intermittency 39%

    Nocturia 85% Incomplete emptying 43%

    Urinary Straining 16%

    incontinence 42%

  • UI/LUTS respond to conservative approaches including behavioural and lifestyle interventions


Mobility
Mobility

  • Reductions in mobility and physical activity common with ageing in all care contexts – results in deconditioning, impaired quality of life and increased risk of falls

  • One third community living older people fall each year

  • Rate of fall related injuries increases with age

  • Fall associated fractures are significant source morbidity and mortality



Urinary incontinence mobility issues
Urinary incontinence & mobility issues

  • Studies indicate reduced activity with UI

  • Studies in different care contexts identified association between UI /LUTS and falls

  • Emerging theory highlights role of urinary incontinence in disablement process

  • Literature review highlights paucity of clinical trials on effective interventions for these overlapping areas to guide practice with older people


Will treating urinary incontinence impact on mobility, physical activity and falls rates in older people?


Review title
Review Title physical activity and falls rates in older people?

The effects of lifestyle and behavioural interventions for urinary incontinence on mobility, physical activity and falls in older people: A systematic review


Aims physical activity and falls rates in older people?

  • To investigate the effectiveness of lifestyle interventions for urinary incontinence on physical activity, mobility and falls in older people

  • To investigate the effectiveness of behavioural interventions to treat urinary incontinence on physical activity, mobility and falls in older people

  • To identify the meaning of urinary incontinence to older people and their experiences of lifestyle and behavioural interventions for their mobility, physical activity and falls.


Types of study
Types of study physical activity and falls rates in older people?

  • Randomised controlled trials, quasi-randomised controlled trials that compare lifestyle and/or behavioural interventions for urinary incontinence versus control (no intervention, usual care or placebo control).

  • Narrative review will include quasi-experimental studies, cohort, observational studies, case control studies and qualitative studies using all methodologies and approaches.


Participants
Participants physical activity and falls rates in older people?

Older people aged 60 years and over, males and females, with any type of urinary incontinence, diagnosed by symptom classification or urodynamic study.

They may be community-living, hospitalised or a care home resident.


Interventions
Interventions physical activity and falls rates in older people?

  • Lifestyle and/or behavioural interventions for LUTS including, but not limited to:

    • pelvic floor muscle training,

    • bladder training,

    • scheduled voiding programmes

    • fluid and caffeine management

    • treatment of constipation

    • weight loss

    • tobacco and alcohol reduction.


Outcomes
Outcomes physical activity and falls rates in older people?

Primary outcomes will focus on subjective and objective measures of :

  • mobility

  • physical activity

  • falls


Contribution to practice
Contribution to practice physical activity and falls rates in older people?

  • Identify specific conservative treatment approaches for UI/LUTS that may impact on older peoples mobility and physical activity and prevent falls

  • Contribute new insights to understanding of falls prevention

  • Highlight need for research to explore relationship between UI/LUTS and mobility, physical activity and falls in older people


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