1. Lower limb muscle strength, balance, mobility and function in older women with urge and mixed urinary incontinence: an observational pilot study
Mélanie Le Berre,1,2 Mélanie Morin,3,4 Hélène Corriveau,3,4 Mathieu Hamel,3,4 Sylvie Nadeau,1,5 Johanne Filiatrault,1,2 Chantale Dumoulin1,2
1Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montreal, Canada
2School of Rehabilitation, Université de Montréal, Montreal, Canada
3Research Centre on Aging, Université de Sherbrooke, Sherbrooke, Canada
4School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Canada
5Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, Canada

2. Background Objectives
After the age of 65, up to 1/2 women may experience symptoms of urinary incontinence (UI).1
A positive correlation between falls and urgency UI (UUI) or mixed UI (MUI) has been identified.2,3 Deficits in physical function and motor skills were mentioned as a possible explanation.3,4
This hypothesis could be of particular relevance for physiotherapy.2 However, lower-extremity impairments in older women with UUI/MUI have not been thoroughly investigated.
Compare the specific characteristics of lower limb muscle strength, balance, mobility and function in older women with and without UUI or MUI;
Explore the association between the severity of the UI symptoms and these characteristics.
1. Milsom et al, 2013; 2. Chiarelli et al, 2019; 3. Foley et al, 2012; 4. Fritel et al, 2013

3. Methods Design Outcome measures Participants
Observational cross-sectional pilot study.
UI symptoms severity
International Consultation Incontinence Questionnaire Urinary Incontinence Short Form (ICIQ-UI SF)
Lower limb muscle strength
Biodex dynamometer
30second Sit-to-Stand
Balance
Single-Leg stance
Four Square Step test (FSST)
Activities-Specific Balance Confidence (ABC) scale
Mobility
10-Meters Walk Test
6-Minutes Walk Test
Function
Human Activity Profile Questionnaire (HAP) adjusted score
SF-12 Physical and Mental Health Summary scores
Participants
Eligible women were:
Aged 65 years and over
Living in the community
Able to walk safely and independently
Either 3 episodes of UI or more per week (UUI/MUI) or no leakage for the last 3 months
They were excluded if unable to understand French/English simple instructions or if they had:
Medical problems, disabilities or comorbidities that may interfere with the study
BMI higher than 35

4. Results Lower limb muscle strength Balance 30° 60° Flex Ext
With urge/mixed UI
No UI
Statistical tests
Single-leg stance - dominant side (sec)
median (min-max)
3.93 ( )
23.99 ( )
p < 0.001
Single-leg stance - non-dominant side (sec)
5.74 ( )
17.97 ( )  
p < 0.005
Four Square Step Test (score)
mean (sd)
8.52 (1.96)
7.86 (1.54)
p = 0.22
Activities-Specific Balance Confidence scale
76.03 (19.05)
88.48 (9.26)
p = 0.01
Flex
Ext

5. Results Mobility Function Conclusion
With urge/mixed UI
No UI
Statistical tests
10-Meters Walk Test (m/sec)
median (min-max)
 1.61 ( )
1.81 ( )
p = 0.01
6-Minutes Walk Test (metres)
mean (sd)
(58.29)
(46.36)
p = 0.46
With urge/mixed UI
No UI
Statistical tests
Human Activity Profile Questionnaire (adjusted score)
median (min-max)
67 (43-81)
74 (3-82)
p = 0.34
SF-12 Physical Health Summary (score)
48.5 ( )
57.0 ( )
p = 0.01
Conclusion
The results from this pilot study suggest balance and mobility impairments in high-functioning older women with UUI/MUI.
More studies are needed to confirm these results.