The feasibility of a multimodal exercise program for sedentary postmenopausal women with urinary incontinence: A pilot randomized controlled trial

  • Yi-Ting Li
    Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Yi-Ju Tsai
    Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
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  • Li-Ying Wang
    School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Yin-Chien Ou
    Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Yao-Lin Kao
    Department of Urology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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  • Kuan-Yin Lin
    Corresponding author at: Department of Physical Therapy, National Cheng Kung University, No. 1, Ta-Hsueh Road, Tainan 701, Taiwan.
    Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan

    Institute of Allied Health Sciences, National Cheng Kung University, Tainan, Taiwan
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      • Multimodal exercise is feasible for sedentary postmenopausal women with urinary incontinence.
      • Multimodal exercise showed promising results in improving symptom severity and quality of life in this population.
      • In this population, the multimodal exercise can be as effective as pelvic floor muscle training alone in improving pelvic floor muscle function.



      The aim was to investigate the feasibility and effects of an eight-week multimodal exercise program in sedentary postmenopausal women with urinary incontinence (UI) compared with pelvic floor muscle training (PFMT) only.

      Study design

      This was a pilot randomized controlled trial. The participants were randomly allocated to either the intervention group (IG), who received a multimodal exercise program that incorporated aerobic exercise, resistance exercise, and PFMT, or the control group (CG), who received PFMT only. The intervention was provided twice weekly for eight weeks.

      Main outcome measures

      The primary outcome was feasibility in relation to consent rate, attendance, withdrawal rate, satisfaction with program, and adverse events. The secondary outcomes included pelvic floor muscle function (assessed using digital palpation and manometry), UI-specific quality of life (QoL) (rated on the International Consultation on Incontinence Questionnaire Lower Urinary Tract Symptoms Quality of Life [ICIQ-LUTSqol]), symptom severity (assessed using the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form [ICIQ-UI SF] and a bladder diary), and physical activity levels (rated on the International Physical Activity Questionnaire- short form [IPAQ]).


      Thirty-three of 63 eligible participants (52.4 %) consented to participate in the study and 26 completed it (IG n = 13, CG n = 13); the withdrawal rate was lower in the IG than in the CG (13.3 % vs 27.8 %). In both groups the attendance rate was 100 % and the satisfaction rate was 84.6 %. No adverse events were reported. The intention-to-treat analysis showed that UI-specific QoL (p = 0.011, mean difference: -5.62, 95 % CI: −9.67 to −1.57) and symptom severity measured using the ICIQ-UI SF (p = 0.001, mean difference: -3.23, 95 % CI: −4.93 to −1.54) were significantly improved in the IG after intervention, while no significant changes were found in the CG after intervention. The daytime frequency (p = 0.001) and number of leakages (p = 0.045) recorded in the bladder diary were significantly reduced in the CG after intervention. No significant differences between groups were found on any of the outcome measurements after intervention, except the daytime frequency from the bladder diary, which was significantly more reduced in the CG than in the IG (p = 0.003, mean difference: -0.28, 95 % CI: −2.25 to 1.67).


      An eight-week multimodal exercise program is feasible for sedentary postmenopausal women with UI, and the multimodal exercise program demonstrated potential benefits for improving UI-specific QoL and symptom severity in this population.
      The trial was registered at (NCT04351750).


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