Exercise Interventions to Improve Pelvic Floor Muscle Functioning in Older Women With Urinary Incontinence: A Systematic Review

Background: An estimated 200 million people worldwide live with urinary incontinence, and women are more affected than men. The World Health Organization and the International Continence Society recommend pelvic floor muscle training to treat urinary incontinence in women. Objective: The purpose of this systematic review was to examine pelvic floor muscle function and understand its impact on urinary incontinence in women older than 50 years. Methods: Medline, PsycINFO, Webscience, CINAHL, and Scopus were searched for articles from 1988 to May 2019. Included studies had a comparison or control group, exercise intervention aimed to train the pelvic floor musculature, women 50 years and older, and had been published in peer-reviewed journals. Results: Eight studies were included in this review. Exercise interventions included home-based as well as supervised pelvic floor muscle-strengthening, and indirect pelvic floor muscle-strengthening exercises via co-contraction of surrounding muscles. All interventions were able to improve pelvic floor muscle strength as well as urinary incontinence symptoms, with bigger improvements found in supervised interventions. Conclusion: This review has shown that exercise interventions targeting the pelvic floor muscles may be effective in improving pelvic floor muscle strength, urinary incontinence symptoms, and even quality of life measures. Exercise interventions that were supervised or included some type of biofeedback device showed greater and faster improvements than interventions without additional assistance.