Physiotherapy-led integrated care (PTICOPE) for bladder symptoms and functional independence: A secondary analysis of a randomized controlled trial.

BACKGROUND

Overactive bladder (OAB) and difficulties with instrumental activities of daily living (IADL) are common among older adults. Existing multidomain interventions aligned with the World Health Organization-Integrated Care for Older People (WHO-ICOPE) framework rarely evaluate urinary symptoms or IADL, leading to a lack of evidence.

OBJECTIVE

Conducting exploratory secondary analysis of a randomized controlled trial (RCT) to determine whether a physiotherapy-led integrated care program (PTICOPE) improved OAB symptoms and IADL compared with usual care in older adults.

METHODS

Exploratory secondary analysis used data from a single-blind RCT involving older adults aged ≥60 years, who were randomized 1:1 to PTICOPE (multidomain interventions, pelvic floor and bladder management component, and adjunct home exercises) or usual care (health education). OAB symptoms and IADL were assessed using the Malay OAB Questionnaire V8 (OAB-V8) and Activities of Daily Living Questionnaire at baseline and 12 weeks. Data were compared using Wilcoxon tests and analysis of covariance adjusted for baseline and age.

RESULTS

Among 70 randomized participants, 63 (32 intervention, 31 control) completed assessments at baseline and 12 weeks. Baseline OAB-V8 scores were comparable between the intervention and control (p= 0.337), but the IADL scores were higher in the intervention group (p= 0.004). At 12 weeks, there were no significant differences between the intervention and control in terms of the adjusted OAB-V8 scores (11.76 ± 0.25 vs 11.22 ± 0.25, p= 0.137, partial η2= 0.036) and the adjusted IADL scores (7.17 ± 0.08 vs 7.08 ± 0.08, p= 0.398, partial η2= 0.012).

CONCLUSION

According to this exploratory secondary analysis, PTICOPE did not significantly improve OAB symptoms or IADL after 12 weeks. These findings should be interpreted cautiously, but they suggest that multidomain integrated care programs may maintain functional stability but are insufficient to improve urinary outcomes without targeted bladder-specific interventions.