Core stability exercise improves urinary incontinence in children

Results of a study presented recently at the 2021 American Urological Association Annual Meeting suggest that core stability exercises improve non-neuropathic urinary incontinence in children.¹

In this study, daytime incontinence decreased in 10 (66.6%) out of 15 participants who performed core stability exercises for 16 sessions.

The outcomes of 30 children with functional urinary incontinence, 23 girls and 7 boys, aged 5 to 12 years, were evaluated using bladder and kidney ultrasounds, uroflowmetry and electromyography (EMG), as well as a 3-day voiding and bowel habit diary. Children were unable to enroll in this study if they had neuropathic disease, anatomical defects, or mental retardation.

Once enrolled, the participants were randomly assigned to 1 of 2 groups. Children in Group A underwent 3 sessions of core stability exercises each week, bimonthly visits and standard urotherapy, which included diet, hydration, scheduled voiding, and toilet training. Children in Group B underwent standard urotherapy.

Sanam Ladi Seyedian, MD

“All patients in Group A received individual training on core stability exercises with and without Swiss ball. Exercises comprised of 10 seconds of submaximal contraction followed by 30 seconds of relaxation. All children were asked to do 20 repetitions of the exercises daily at home, under parental supervision for 6 months,” presenter and co-author Sanam Ladi-Seyedian explained. “Core exercises with Swiss ball were performed in a child-friendly environment. Ball exercises were performed in front of a wall bar to prevent the ball from rolling away.”

The same 3 measures of evaluation performed prior to the study (ultrasounds, uroflowmetry/EMG and 3-day voiding diary) were also taken at the end of the treatment sessions and 6 months after. The study showed that while about 67% of Group A had improved daytime incontinence, only 20% (3 out of 15 patients) of Group B experienced improved incontinence at the end of the treatment sessions.

“The improvement of daytime incontinence in Group A was statistically significant compared to Group B at the end of treatment sessions, as well as after 6 months,” said Ladi-Seyedian.

In addition, urine flow pattern normalized in 12 (80%) out of 15 children who were in Group A, but only normalized in 3 (20%) out of 12 children in Group B after the treatment (P = .02). Similarly, EMG activity during voiding normalized in 14 (93%) out of 15 children who were in Group A, and only normalized in 5 (33%) out of 15 children in Group B after the treatment (P = .001).

“This study showed that core stability exercises can be an effective, safe, and reproducible modality for treatment of functional urinary incontinence in children,” Ladi-Seyedian concluded.

Reference

1. Sharifi-Rad L, Ladi-Seyedian SS, Rahimi A, Sokhangoei. Impact of core stability exercises on functional urinary incontinence in children. Paper presented at: 2021 American Urological Association Annual Meeting