Efficacy of a Therapeutic Pelvic Yoga Program Versus a Physical Conditioning Program on Urinary Incontinence in Women : A Randomized Trial.

Autor:	Huang AJ; Department of Medicine, Department of Urology, and Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California (A.J.H.)., Chesney M; Department of Medicine, and Osher Center for Integrative Health, University of California San Francisco, San Francisco, California (M.C.)., Schembri M; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, San Francisco, California (M.S.)., Raghunathan H; Department of Medicine, University of California San Francisco, San Francisco, California (H.R.)., Vittinghoff E; Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California (E.V.)., Mendes WB; Department of Psychology, Yale University, New Haven, Connecticut (W.B.M.)., Pawlowsky S; San Francisco State University, San Francisco, California (S.P.)., Subak LL; Department of Obstetrics and Gynecology, Stanford University, Stanford, California (L.L.S.).
Jazyk:	angličtina
Zdroj:	Annals of internal medicine [Ann Intern Med] 2024 Oct; Vol. 177 (10), pp. 1339-1349. Date of Electronic Publication: 2024 Aug 27.
DOI:	10.7326/M23-3051
Abstrakt:	Background: Pelvic floor yoga has been recommended as a complementary treatment strategy for urinary incontinence (UI) in women, but evidence of its efficacy is lacking. Objective: To evaluate the effects of a therapeutic pelvic floor yoga program versus a nonspecific physical conditioning program on UI in women. Design: Randomized trial. (ClinicalTrials.gov: NCT03672461). Setting: Three study sites in California, United States. Participants: Ambulatory women aged 45 years or older reporting daily urgency-, stress-, or mixed-type UI. Intervention: Twelve-week program of twice-weekly group instruction and once-weekly self-directed practice of pelvic floor-specific Hatha yoga techniques (pelvic yoga) versus equivalent-time instruction and practice of general skeletal muscle stretching and strengthening exercises (physical conditioning). Measurements: Total and type-specific UI frequency assessed by 3-day voiding diaries. Results: Among the 240 randomly assigned women (age range, 45 to 90 years), mean baseline UI frequency was 3.4 episodes per day (SD, 2.2), including 1.9 urgency-type episodes per day (SD, 1.9) and 1.4 stress-type episodes per day (SD, 1.7). Over a 12-week time period, total UI frequency (primary outcome) decreased by an average of 2.3 episodes per day with pelvic yoga and 1.9 episodes per day with physical conditioning (between-group difference of -0.3 episodes per day [95% CI, -0.7 to 0.0]). Urgency-type UI frequency decreased by 1.2 episodes per day in the pelvic yoga group and 1.0 episode per day in the physical conditioning group (between-group difference of -0.3 episodes per day [CI, -0.5 to 0.0]). Reductions in stress-type UI frequency did not differ between groups (-0.1 episodes per day [CI, -0.3 to 0.3]). Limitation: No comparison to no treatment or other clinical UI treatments; conversion to videoconference-based intervention instruction during the COVID-19 pandemic. Conclusion: A 12-week pelvic yoga program was not superior to a general muscle stretching and strengthening program in reducing clinically important UI in midlife and older women with daily UI. Primary Funding Source: National Institutes of Health. Competing Interests: Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-3051.
Databáze:	MEDLINE
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