Standing Postural Balance Control in Women with and Without Urinary Incontinence: A Systematic Review.

INTRODUCTION AND HYPOTHESIS: Most women suffering from urinary incontinence (UI) report that leakage occurs during everyday movement. These precise observations raise a potential association between standing postural control and UI. The aim of this systematic review is to compile studies investigating the link between standing postural control and UI, according to the presence or absence of UI, the severity of UI and bladder fullness.

METHODS

This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Observational studies providing data on standing postural control in women with and without UI were considered for inclusion.

RESULTS

Ten studies met the inclusion criteria, representing 4262 middle-aged and older active women. According to the modified version of the Newcastle-Ottawa quality assessment Scale, one was study rated as having a high risk of bias, 3 studies fair quality and 6 good quality. Four studies reported results using stabilographic measurement (p = 124 women). Six reported results using standing balance tests (p = 4138). All studies revealed some differences between UI and non-UI groups in standing postural control (p < 0.05).

CONCLUSIONS

Our analysis provides a high level of evidence that women with UI have more impaired standing postural balance control than women without UI. According to the dual-task theory, worsening continence control is associated with a decline in standing postural balance, and conversely, a decline in standing postural balance is associated with the development of UI. Developing prospective planned physiotherapy intervention studies that address the impact of standing postural control interventions on UI signs and symptoms seems advisable.