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MOBILITY AND URINARY INCONTINENCE: INFLUENCES AND CONSEQUENCES
Coll Planas L; Becker C; Nikolaus Th
Mobility impairment hampers the use of the toilet and causes or aggravates incontinence. Strength and lower body mobility impairment were found predictors for the onset of incontinence. Thus, strength training could prevent incontinence. But on the other hand, incontinence is known as a barrier to physical activity, which means that training should be adapted to incontinent patients to increase the adherence. Furthermore, urge incontinence can cause functional impairment through the increased risk of falls and fractures. This could mean that early diagnosis and drug therapy of urge incontinence reduce the risk of falls and fractures, but also environmental interventions like bathroom in close proximity and availability of a bedside commode. Maybe the increased risk of falling by urge incontinence is a question of difficulty of dual task, where a limited divided attention would exacerbate postural instability. If so, training on dual attention tasks would be the appropriate intervention. Also some neurological diseases can cause functional impairment and incontinence at the same time, for example normal pressure hydrocephalus, Parkinson and dementia with Lewy bodies. Cerebral white matter changes were found to be correlated with urinary incontinence and gait disturbances by Alzheimer?s Dementia but also among elderly with cardiovascular risk factors. So the treatment of modifiable cardiovascular risk factors could prevent incontinence and mobility impairment. Another point of view is the multifactorial etiology of geriatric syndromes: incontinence and functional dependence would appear when impairments in multiple domains compromise the compensatory ability.
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