Urinary Incontinence Among Group Fitness Instructors Including Yoga and Pilates Teachers. Bo K, et al. Neurourology and Urodynamics 30:370-373 (2011).

Pelvic Physiotherapy Think Tank

July 10, 2013 Michelle Spicka, DPT

Objective:  The aim of this study was to investigate the prevalence of urinary incontinence (UI) among female group fitness instructors, including Pilates and yoga teachers. 

Study Design/Method:  This was a cross-sectional study using an online questionnaire to evaluate health issues in group fitness instructors in Norway.  847 (152 men and 685 women) Fitness instructors responded to the survey.  The questionnaire contained questions about age, education, number and types of classes taught per week, exercise history, height and weight, injuries and different health issues. 

The International Consultation on Incontinence Questionnaire- UI short form was used to assess UI which assesses frequency, severity and perceived impact of incontinence in addition to an unscored self-diagnostic item.

Outcome/Results:  

1.       2% of the men and 26.4% of the women reported UI

2.       Most of the instructors reported to have SUI

3.       21.8% had leakage >once a week, 3.2% 2-3 times/wk, 1.4% > once/day

4.       24.8% reported the leakage to be small to moderate

5.       Female instructors who were older, had been teaching for a longer period of time, and were not using oral contraceptives had a statistical significant higher prevalence of UI

6.       The prevalence of UI in instructors teaching yoga/Pilates was 25.9%

Conclusion:

1.       This study found a similar prevalence of UI in group fitness instructors as has been shown in the general female population and yoga and Pilates instructors reported a prevalence equal to that of other fitness instructors.

2.       There was no evidence, in this study, that a history of eating disorders or the presence of irregular menstruation lead to a higher prevalence of UI.  However, eating disorder history was self-reported and the findings in this study support the current consensus suggesting that estrogen depletion is not a risk factor for UI.

3.       This study shows that general exercise does not seem to protect against UI and confers with many studies showing a high prevalence among exercisers.

a.       Exercise may only unmask an underlying condition, which would not have been revealed if the woman was sedentary

Thought Questions:

1.       Fitness instructors are in a unique position to teach PFMT (pelvic floor muscle training) to a huge number of women and this study indicates that many instructors are in need of training the pelvic floor themselves.

2.       Many yoga and Pilates instructors claim that they incorporate PFMT into other exercises and that this training is effective in teaching PFMT but the prevalence of UI in those instructors is the same as other fitness instructors.

Further Discussion:

Tremback-Ball, et al. Young Women’s Urinary Incontinence Perceived Educational Needs.  J Womens Health Phys Ther.  Vol 37 Jan/April 2013. 29-34,

Summary:

1.       15% of the women (N= 327) surveyed indicated that they experienced UI

2.       Of the 15%, only 31.9% said that they would consider seeking professional help for incontinence

3.       Approximately 71% of all surveyed felt that women were not able to talk about UI freely, although most (51.1%) were aware that there are professionals to help with UI.

4.       The findings of this study support the idea that incontinence is a socially unacceptable topic of discussion.

Elbiss et al. Social Impact and Healthcare-seeking Behavior Among Women with UI in the United Arab Emirates. Int J Gynaecol Obstet. 2013 June 10.

Summary:

1.       Prevalence of UI was 42.2% in 429 women studied

2.       50% did not seek medical advice stating the following reasons: hoped for spontaneous resolution of UI (61.9%); embarrassed to visit a male or female clinician (35.9%); believed that UI was a normal occurrence among women (31.5%); unaware that treatment was available (23.9%)