Yoga to Enhance Behavioral Self-Management of Urinary Incontinence in Women

瑜伽增强女性尿失禁的行为自我管理

• 批准号: 8767728
• 负责人: Alison Huang
• 金额: $ 29.85万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-01 至 2017-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8767728
• 关键词: Address; Adverse effects; Affect; Aftercare; Anatomy; Anxiety; Attention; Autonomic nervous system; Awareness; Behavior Therapy; Behavioral; Bladder; Bladder Control; Caring; Chronic; Clinical Trials; Clinical Trials Design; Control Groups; Data; Educational process of instructing; Equilibrium; Exercise; Frequencies; Goals; Group Structure; Health; Home environment; Impedance Cardiography; Incontinence; Instruction; Intervention; Life; Measures; Mental Depression; Mental Health; Mixed Incontinence; Operative Surgical Procedures; Outcome; Participant; Patients; Pelvic Floor Muscle; Pelvic floor structure; Pharmaceutical Preparations; Pilot Projects; Posture; Procedures; Quality of life; Questionnaires; Randomized; Randomized Controlled Trials; Recruitment Activity; Relative (related person); Relaxation; Reporting; Research; Risk; Safety; Self Management; Social isolation; Stress; Stretching; Structure; Techniques; Testing; Therapeutic; Therapeutic Intervention; Time; Training; Treatment Efficacy; United States; Urinary Incontinence; Woman; Writing; Yoga; abstracting; aged; alternative treatment; base; design; diaries; efficacy trial; expectation; experience; follow-up; functional decline; heart rate variability; improved; insight; middle age; muscle strength; older women; physical conditioning; pilot trial; programs; response; routine care; success; treatment duration; treatment response; treatment strategy

1R34AT008028 PI: Huang, Alison Revised Abstract Over 20 million women in the United States suffer from urinary incontinence, a condition leading to depression, social isolation, functional decline, and loss of ability to live independently. First-line treatment for incontinence consists of behavioral management strategies such as pelvic floor muscle exercises that are difficult for women to lean to practice effectively in course of routine care. Second-line treatments have problematic side effects or other limitations that decrease their safety and accessibility, particularly for older women who are at greatest risk of developing incontinence. As a result, alternate treatment strategies are needed that are not only effective but also more accessible and better tolerated. Yoga is a complementary behavioral intervention with the potential to improve bladder control through multiple mechanisms. When practiced in a way that emphasizes mindful awareness of specific bodily structures, yoga can be used to increase women’s control over their pelvic floor muscles, improve their autonomic nervous system balance, and decrease underlying stress and anxiety, all of which may alleviate incontinence. To explore the preliminary efficacy and safety of yoga to treat incontinence, our research team developed a structured, group-based yoga therapy program involving twice weekly group yoga classes supplemented by once weekly home yoga practice. In a pilot trial of ambulatory middle-aged and older with frequent stress, urgency, or mixed incontinence, women randomized to this yoga therapy program showed on over 50% greater reduction in incontinence frequency relative to a waitlist control. We now propose to conduct an R34-scale pilot study to test and refine procedures for a more rigorous, full-scale efficacy trial of yoga for treatment of incontinence in middle-aged and older women. We will randomize at least 50 ambulatory middle-aged and older women with urgency, stress, or mixed-type incontinence to take part in either a group-based yoga therapy program or a time-equivalent stretching/strengthening exercise control program. Using data collected over 12 weeks of treatment and 12 weeks of post-treatment follow-up, we will examine the feasibility of recruiting and retaining ambulatory middle-aged and older women in this trial design, collect preliminary data on the effects of the yoga intervention on incontinence and related quality-of-life outcomes, and explore potential differences in treatment efficacy by duration of treatment and follow-up.

1R34AT008028 PI：黄，艾莉森 修订摘要 在美国，超过2000万妇女遭受尿失禁，这种疾病导致抑郁症，社会孤立，功能下降以及独立生活的能力丧失。对尿失禁的一线治疗包括行为管理策略，例如骨盆底肌肉运动，这些策略很难在常规护理过程中有效地倾斜地倾斜。二线治疗具有有问题的副作用或其他限制，可以降低其安全性和可及性，尤其是对于有尿失禁风险的老年妇女。结果，需要替代治疗策略，这些策略不仅有效，而且更易于访问且耐受性更好。瑜伽是一种完整的行为干预，具有通过多种机制改善膀胱控制的潜力。当以一种强调对特定身体结构的意识的方式进行练习时，瑜伽可用于增加妇女对骨盆底肌肉的控制，改善其自主神经系统平衡，并减轻潜在的压力和焦虑，所有这些都可能减轻尿失禁。为了探索瑜伽治疗尿失禁的初步效率和安全性，我们的研究团队开发了一项基于小组的瑜伽疗法计划，涉及每周两次，每周一次的家庭瑜伽练习。在一项针对频繁的压力，紧迫性或混合失禁的中年和较旧的试验试验中，与候补名单控制相比，失禁频率的降低超过50％。现在，我们建议进行一项R34规模的试点研究，以测试和完善程序，以对瑜伽进行更严格，更全面的试验，以治疗中年和老年妇女的尿失禁。我们将至少有50名具有紧迫性，压力或混合型尿失禁的中年和老年妇女参加基于小组的瑜伽治疗计划或时间等效的伸展/加强运动控制计划。在此试验设计中，使用在12周的治疗过程中收集的数据和治疗后的12周后续随访，我们将研究招募和保留卧床中年和老年妇女的可行性，收集有关瑜伽干预对失毒和相关质量质量生活效果的影响的初步数据，并探索治疗效率在治疗和随访中的潜在差异。