Wii Fit Game Based Abdomino-Pelvic Training In Urinary Incontinence
Condition: Incontinence, Urinary
MeSH terms: Urinary Incontinence; Enuresis
Study type: Interventional

Summary: 
      This study is aimed to determine the effect of Wii fit based abdomino-pelvic training on
      strength of pelvic floor muscles and on symptoms of urinary incontinence in females. An
      experimental, randomized controlled trial will be performed. Both reproductive and
      postmenopausal females with stress urinary incontinence will be included. 40 participants
      would be randomly distributed in experimental group (n=20) receiving wii fit based
      abdomino-pelvic training and control group (n=20) receiving conventional pelvic floor
      exercises. Pelvic floor strength would be assessed before and after by Digital method and EMG
      biofeedback. Urinary symptoms would be assessed by bladder diary, pad test and International
      consultation on Incontinence Questionnaires. Health related Quality of life questionnaire
      would also be used as an outcome measure. Data will be analyzed on SPSS 21 version using
      descriptive and inferential statistics
    

Detailed description: 
      Loss of bladder control results causes the accidental leak of urine is called urinary
      incontinence. It may be slightly bothersome or totally debilitating. It may leads to
      embarrassment and keeps them away from enjoying many physical activities, including
      exercising. Urinary incontinence may develop emotional distress because of some outside
      factors, such as difficulty getting to standing position or only being able to walk slowly,
      which prevent them from getting to the toilet on time.

      Old women experience urinary incontinence more than young women or young girls. Muscles in
      the wall of bladder contracts during urination. Sphincter muscles surrounding the urethra
      relax which let the urine to pass out from the body. Incontinence will occur when the muscles
      of bladder suddenly contracts or are not strong enough to hold back the urine. Then the urine
      may escape with less pressure than usual when the muscles are damaged, this causing a change
      in the position of the bladder.

      Stress incontinence is the most common type of urinary incontinence. 80% of the females
      suffering from urinary incontinence have stress urinary incontinence. Obese women having
      greater intra-abdominal pressure leads to weakening of pelvic floor muscle which causes
      stress incontinence.

      During pregnancy, child birth and menopause physical changes results in the weakening of
      muscles of bladder. As the result of physical exertions, muscles of bladder become weak that
      increase intra-abdominal pressure leakage may cause. Leakage may occur during coughing,
      sneezing or heavy lifting.

      Wii fit games are computer-generated scenario that simulates experience through senses and
      perception. This approach is being used by physical therapist so than their patient stick to
      their exercise protocol and it enhance their training and functional level. Wii fit game
      based pelvic floor muscle exercises helps the pelvic floor muscle to strengthen by different
      movements such as anteversion,, retroversion, lateral tilting, truck rotation, circumduction
      and pelvic stabilization. video game based treatment that enhance patients' motivation,
      functional training and hence adherence to exercise regimen. As clinical practice in women's
      health physical therapy lacks options for pelvic floor muscle training and wii fit game based
      pelvic floor rehabilitation is an innovated method so could be a valuable adjunct in
      management of female urinary incontinence protocol.
    

Intervention name(s): Wii Fit Training Experimental Group; Conventional Training
Intervention type(s): Other; Other
Intervention description(s): Experimental group receiving wii fit game based abdomino-pelvic training. A specific protocol was developed by the researchers. Wii fit games which promote exercises focusing on the abdominopelvic cavity strengthening, using as a therapeutic means a Wii™ console with a Wii Fit Plus™ CD game. The protocol was design that which playing games participant perform different pelvic movements such as anteversion, retroversion, lateral tilt and circumduction that maintain trunk control and stabilization with mild abdomino-pelvic muscle activation. Duration of each game is 5 minutes with 90 seconds interval between them twice a week. After performing the sequence of virtual games, a series of abdominopelvic and lower limb muscle stretching exercises will done.; Control group (n=20) receiving conventional pelvic floor exercises. Conventional exercises includes:
Knack Maneuver (Ashton -Miller 1998, 2008)
Pelvic floor strengthening: kegel Exercise.
-Lumbo-Pelvic Stabilization Exercise.
Functional Training/ PFM Contraction during ADL
Correction of biomechanical/structural deformities
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Experimental group
Masking: Single (Participant)
Primary purpose: Other
Keywords: Wii Fit; Urinary Incontinence; Females; Abdomino-Pelvic Training