An integrated exercise and bladder training intervention to reduce falls in older women with urinary incontinence

综合运动和膀胱训练干预措施可减少患有尿失禁的老年女性跌倒的情况

• 批准号: 10365889
• 负责人: Uduak Umoh Andy
• 金额: $ 66.64万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-30 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10365889
• 关键词: Address; Admission activity; Affect; Age; Aging; Anti-Cholinergics; Anxiety; Attitude; Behavioral; Biological Markers; Bladder; Bladder Control; Clinical effectiveness; Communities; Consultations; Control Groups; Dependence; Education; Educational Intervention; Effectiveness; Elderly; Elements; Environmental Hazards; Equilibrium; Exercise; Extravasation; Fall prevention; Fracture; Goals; Hazard Assessment; Health; Home; Incontinence; International; Intervention; Life; Link; Lower Extremity; Measures; Mental Depression; Minority; Mission; Modeling; Morbidity - disease rate; Nursing Homes; Outcome; Outcome Study; Patients; Pharmaceutical Preparations; Physical Exercise; Physical environment; Pilot Projects; Prevention; Psyche structure; Public Health; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Research; Research Personnel; Role; Shame; Social isolation; Stroke; Symptoms; Techniques; Testing; Training; United States National Institutes of Health; Urban Community; Urinary Incontinence; Urine; Woman; base; diaries; disability; effective intervention; efficacy testing; exercise intervention; experience; fall risk; falls; high risk population; improved; innovation; marginalized population; men; micturition urgency; muscle strength; novel; older women; preventive intervention; primary outcome; programs; recruit; secondary outcome; social expectations; social stigma

Project Summary/Abstract Urgency urinary incontinence (UUI) is a biomarker of falls risk and disproportionately affects older minority women living in urban communities. Over 50% of an estimated 10 million women age 70 and older with UUI will experience a fall. A fall compounds the functional dependency already present in older women with UUI making their quality of life worse than that following a stroke. This proposal addresses a key research gap: existing fall prevention interventions cannot be applied to women with UUI and effective interventions that reduce falls in older community-dwelling women with UUI are lacking. Our objective is to establish the effectiveness of a novel multidimensional intervention to reduce falls in older women with UUI. This intervention is based on the hypothesis that falls in older adult women with urinary incontinence are the result of urinary urgency related anxiety in the setting of reduced lower limb muscle strength, poor balance, and environmental hazards. Our trial will show that a tailored intervention that addresses each of these interdependent factors through integrated behavioral bladder training and urge suppression, strength and balance exercises, and home hazard assessment will reduce falls and improve urinary incontinence in older community-dwelling women with UUI. The investigators of this proposal have already developed and validated the intervention in pilot studies and now propose a randomized controlled trial of 314 women to rigorously establish its effectiveness. Our specific aims are: 1) To determine the effect of a tailored integrated exercise and bladder training intervention on falls in older women and 2) To determine the effect of a tailored integrated exercise and bladder training intervention on urgency urinary incontinence in older women. The trial will use a community-engagement approach to recruit women living in an urban core community with high proportion of minorities. This trial will be the first adequately powered study to test an intervention for reducing falls in older community-dwelling women with urgency urinary incontinence and also the first adequately powered study to test the efficacy of a physical exercise intervention for the treatment of urinary incontinence. This study will have significant public health impact because it will establish the clinical effectiveness of a scalable intervention that targets two common highly morbid conditions: falls and incontinence in older women.

项目总结/摘要 急迫性尿失禁（UUI）是福尔斯风险的生物标志物，不成比例地影响老年人 生活在城市社区的妇女。在估计的1000万70岁及以上的UUI妇女中， 经历一次跌倒。跌倒加重了UUI老年女性已经存在的功能依赖性 他们的生活质量比中风后更差。该提案解决了一个关键的研究空白：现有的瀑布 预防干预措施不能应用于UUI妇女，有效的干预措施，减少福尔斯， 社区老年妇女UUI缺乏。我们的目标是建立小说的有效性 多方面干预以减少UUI老年女性的福尔斯。这种干预是基于 老年尿失禁女性的福尔斯跌倒是尿急相关的结果的假设 在下肢肌肉力量下降、平衡能力差和环境危害的情况下的焦虑。我们的试验 将表明，一个有针对性的干预，解决这些相互依存的因素，通过综合 行为膀胱训练和冲动抑制，力量和平衡练习，以及家庭危险 评估将减少福尔斯和改善尿失禁的老年社区居民妇女UUI。 该提案的研究人员已经在试点研究中开发并验证了干预措施， 建议对314名妇女进行随机对照试验，以严格确定其有效性。我们的具体目标 目的：1）确定一个量身定制的综合运动和膀胱训练干预对老年人福尔斯的影响。 2）确定量身定制的综合锻炼和膀胱训练干预对女性的影响， 老年女性的急迫性尿失禁该试验将采用社区参与的方法招募 生活在少数民族比例较高的城市核心社区的妇女。这次审判将是第一次充分 一项检验干预措施减少社区老年女性尿急患者福尔斯跌倒的有力研究 这也是第一个有足够动力测试体育锻炼干预效果的研究 用于治疗尿失禁。这项研究将产生重大的公共卫生影响，因为它将 确定针对两种常见高度病态的可扩展干预措施的临床有效性： 老年妇女的福尔斯和尿失禁。