Combining Pelvic Floor Rehabilitation With Postural Re-education in Women With Stress Urinary Incontinence and Chronic Low Back Pain: a Preliminary Study.
Condition: Stress Urinary Incontinence; Low Back Pain
MeSH terms: Urinary Incontinence; Enuresis; Urinary Incontinence, Stress; Back Pain; Low Back Pain
Study type: Interventional

Summary: 
      Stress Urinary incontinence (SUI) is a common health condition in female population. Although
      its prevalence increases with the age, women of all ages could be affected. Several
      epidemiological studies have shown an association of SUI with Low Back Pain (LBP)
      demonstrating, moreover, that the presence of one condition may predispose the patient to the
      onset of the other. Concerning the LBP, the clinical practice guidelines provided
      recommendations for physical rehabilitative treatment. Different techniques and physical
      exercises have been developed and it is difficult at the date to affirm the superiority of
      one approach as compared to another. Moreover, the crucial role plays by the pelvic floor
      muscles (PFM) both as an integral part of trunk and lumbo-pelvic stability and in maintenance
      of urinary continence, lead the pelvic floor muscles disfunction to be associated both with
      SUI and LBP, making the PFM rehabilitation a useful approach in both the conditions. In this
      rehabilitative context the present study aims to verify the effectiveness of a global
      physical approach based on postural re-education combined to the pelvic floor rehabilitation
      in women with diagnosis of stress urinary incontinence associated with non-specific chronic
      low back pain.
    


Intervention name(s): Postural re-education; Spinal mobilization; Perineal Exercises
Intervention type(s): Other; Other; Other
Intervention description(s): Each session of the experimental approach will be composed of 40 minutes of postural exercise. Participants will be asked to maintain two different postures to stretch both the anterior and posterior muscle chains. The first posture will consist of lying on the back maintaining the extension of the legs to release the respiratory diaphragm and stretch the anterior muscle chain. For the second posture, participants wiil be asked to lie on their back with their legs flexed to stretch the posterior chai. For each posture, the physical therapist will use verbal commands and manual contact to maintain alignment and make the necessary postural corrections to optimize the stretching and discourage compensatory movements.
10 sessions of the allocated intervention will be performed and organized in 2 times a week for 5 weeks.; This approach will consist of 40 minutes of thoracolumbar spine mobilization. Two different mobilizations will be carried out. In the first one the patient will be in sitting position with both legs out of the bed and a mobilization in antero-posterior direction will be provide by the physiotherapist; the second one will consist in rotational mobilisation provide with the patient in lateral decubitus position.
10 sessions of the allocated intervention will be performed and organized in 2 times a week for 5 weeks.; Perineal Exercises will be performed in both the allocated approach. The protocol will consist in 10 minutes of perineal contraction and relaxation and 10 minutes of stretch-reflex for a total of 20 minutes of perineal exercises.10 sessions of the allocated intervention will be performed and organized in 2 times a week for 5 weeks.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment