There is not yet strong evidence that exercise regimens other than pelvic floor muscle training can reduce stress urinary incontinence in women: a systematic review

Question: What evidence is there for alternative exercises to specific pelvic floor muscle training for treatment of stress urinary incontinence in women?

Design: A systematic review was conducted with searches of PubMed and PEDro to January 2013. The quality of randomised trials was evaluated using the PEDro scale. Each type of exercise was classified as being in a Development Phase, Testing Phase, or Refinement and Dissemination Phase.

Participants: Women with stress or mixed urinary incontinence with predominantly stress urinary incontinence.

Intervention: Exercise regimens other than pelvic floor muscle training.

Outcome measures: The primary outcome was urinary leakage.

Results: Seven randomised controlled trials were found: three on abdominal training, two on the Paula method, and two on Pilates exercise. The methodological quality score ranged between 4 and 8 with a mean of 5.7. There was no convincing evidence for the effect of these exercise regimens so they remain in the Testing Phase. Because no randomised trials were found for posture correction, breathing exercise, yoga, Tai Chi, and general fitness training, these were classified as being in the Development Phase.

Conclusion: There is not yet strong evidence that alternative exercise regimens can reduce urinary leakage in women with stress urinary incontinence. Alternative exercise regimens should not yet be recommended for use in clinical practice for women with stress urinary incontinence.