Neutral posture education during cough can reduce urine leakage in women with cough-related stress urinary incontinence.

Contrôle moteur postural Cough Femme Incontinence urinaire à l’effort Muscles du plancher pelvien Pelvic floor muscles Postural motor-control Quality of life Qualité de vie Stress urinary incontinence Toux Women

Journal

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie
ISSN: 1166-7087
Titre abrégé: Prog Urol
Pays: France
ID NLM: 9307844

Informations de publication

Date de publication:
Dec 2023
Historique:
received: 20 07 2023
revised: 03 09 2023
accepted: 04 09 2023
medline: 27 11 2023
pubmed: 28 9 2023
entrez: 27 9 2023
Statut: ppublish

Résumé

Current literature highlights the difficulty in identifying an optimal educational technique for maintaining continence during cough. To characterize the effects of an educational intervention focusing on neutral posture during cough in women with cough-induced urinary incontinence (UI). This interventional study design included women with cough-induced UI. We recorded PFMs surface electromyographic (sEMG) peak activity, and assessed symptoms and quality of life (QoL) 6 weeks after the intervention. The effect of the experimental situation was estimated using a linear mixed model, sEMG measurements during coughing were indexed to each situation and adjusted to the resting value at, and a moderation analysis was used. Eighteen participants were included. The measurement situations (control versus experimental) did not have a statistically significant impact on sEMG peak activity during coughing: mean effect [95% CI] 3.42 [-1.28; 7.66]. Six weeks post-intervention, participants reported statistically significant decrease in urinary symptoms (P=0.0246) and significant improvement in QoL (P=0.00776). This was also particularly marked on the dimension related to effort activities (P=0.00162). This study suggests that a brief educational intervention focusing on neutral posture during cough, without voluntary pre-contraction of the PFMs, has no clinically significant influence on sEMG peak activity of the PFMs in women with cough-induced UI. However, this intervention can lead to a significant improvement in urinary symptoms and QoL at 6 weeks. These improvements seem to be independent of electromyographic PFMs peak activity recorded during cough. As such, our preliminary results pave the way for future research. NP4.

Sections du résumé

BACKGROUND BACKGROUND
Current literature highlights the difficulty in identifying an optimal educational technique for maintaining continence during cough.
OBJECTIVE OBJECTIVE
To characterize the effects of an educational intervention focusing on neutral posture during cough in women with cough-induced urinary incontinence (UI).
METHODS METHODS
This interventional study design included women with cough-induced UI. We recorded PFMs surface electromyographic (sEMG) peak activity, and assessed symptoms and quality of life (QoL) 6 weeks after the intervention. The effect of the experimental situation was estimated using a linear mixed model, sEMG measurements during coughing were indexed to each situation and adjusted to the resting value at, and a moderation analysis was used.
RESULTS/FINDINGS RESULTS
Eighteen participants were included. The measurement situations (control versus experimental) did not have a statistically significant impact on sEMG peak activity during coughing: mean effect [95% CI] 3.42 [-1.28; 7.66]. Six weeks post-intervention, participants reported statistically significant decrease in urinary symptoms (P=0.0246) and significant improvement in QoL (P=0.00776). This was also particularly marked on the dimension related to effort activities (P=0.00162).
CONCLUSION CONCLUSIONS
This study suggests that a brief educational intervention focusing on neutral posture during cough, without voluntary pre-contraction of the PFMs, has no clinically significant influence on sEMG peak activity of the PFMs in women with cough-induced UI. However, this intervention can lead to a significant improvement in urinary symptoms and QoL at 6 weeks. These improvements seem to be independent of electromyographic PFMs peak activity recorded during cough. As such, our preliminary results pave the way for future research.
LEVEL OF EVIDENCE METHODS
NP4.

Identifiants

pubmed: 37758607
pii: S1166-7087(23)00204-X
doi: 10.1016/j.purol.2023.09.002
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1083-1091

Informations de copyright

Copyright © 2023 Elsevier Masson SAS. All rights reserved.

Auteurs

B Steenstrup (B)

Rouen University Hospital, Department of Urology, Rouen, France; La Musse Clinical Research Department and Physiotherapy Training Institute (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France. Electronic address: Benoit.Steenstrup@chu-rouen.fr.

M Pelleray (M)

La Musse Clinical Research Department and Physiotherapy Training Institute (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France.

J N Cornu (JN)

Rouen University Hospital, Department of Urology, Rouen, France.

S Verdun (S)

Lille Catholic hospitals, Biostatistics Department- Delegations for Clinical Research and Innovation, Lille Catholic University, Lille, France.

M Gilliaux (M)

La Musse Clinical Research Department and Physiotherapy Training Institute (Fondation La Renaissance Sanitaire), Saint-Sébastien-de-Morsent, France; Clinical Research Department, Axinesis, Wavre, Belgium.

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