Fizioterapevt · Feb 20, 2026
Rehabilitation program for senil urinary incontinence in women
By Markosyan TG, Kotenko KV, Ageev D et al.
The aim of this study was to evaluate the effectiveness of a musculoskeletal exercise program that increases endurance and gait speed as a rehabilitation method for senile urinary incontinence. Materials and methods: Forty-eight women aged 58 to 67 years (mean age 61.2 ± 3.2 years) with urinary incontinence, primarily in the upright position, were examined. The IPSS QOL voiding quality questionnaire was administered, the ICIQ SF index was assessed, and voiding diaries were kept. A comprehensive urodynamic study and needle electroneuromyography of the perineum and lower extremities were performed. Balance and gait were assessed using the Tinetti scale. The rehabilitation program included one-hour gymnastics sessions once a week, as well as fitness exercises: body awareness, breathing exercises, relaxation, and strength training of the thigh, abdominal, and back muscles using exercise balls. The rehabilitation program lasted five months. Results. At baseline, patients demonstrated a high risk of falls (<20 points on the Tineti scale), with balance being less affected than gait disturbances. At five-month follow-up, all subjects demonstrated improved gait, increased walking endurance, and increased walking speed, as well as a reduction in urinary incontinence. Quality of life and social adaptation significantly improved. Analysis of the ICIQ SF scores showed a decrease to 5.9, reflecting activation of the guard reflex and, consequently, urinary continence. All patients experienced a decrease in urinary incontinence, a disappearance of urgency, and a reduction in the frequency of urination to 5–6 times per day. The use of pads was reduced to 1–2 times per day, with no need to use them during sleep. ENMG revealed signs of denervation of the perineal and lower extremity muscles, as evidenced by a 1.71‑fold increase in the average MUAP duration and a 2.2‑fold increase in MUAP amplitude. Furthermore, conduction disturbances in the corticospinal tract were recorded, with an increase in cortical and segmental motor response latency by 17 % and 25 %, respectively, and an 18 % increase in central motor conduction time. These parameters returned to normal as a result of rehabilitation treatment. Conclusion. A link was found between gait disturbances and urinary incontinence in a group of elderly female patients, as a common manifestation of geriatric pathology and aging. A 5‑month course of therapy, including lower extremity gymnastics, improves patients’ gait, balance, and stability, strengthens the pelvic floor muscles and urinary sphincter apparatus, thereby improving urinary continence. The results indicate that older women are able to integrate motor skill training strategies to improve pelvic floor muscle function.