A study that fits within our era of healthy aging. Does having an active lifestyle effects the occurrence of urinary loss? A popular question in clinical practice.
Previous studies managed to prove that above a BMI of >25 the risk of stress (urinary) incontinence increases as BMI increases. Moreover, a poor condition, nutritional health and general health status influence the functional loading capacity of the pelvic floor.
In this prospective study, a number of explanations is provided for the association between physical activity and urinary loss. One of these explanations is that the participants of the study perhaps already performed pelvic floor exercises, which reduce the risk of urinary incontinence. However, this is merely an assumption, and it has not been examined. This is an interesting research question: does the combination of more physically active lifestyle and pelvic floor exercises reduce the risk of urinary incontinence even more?
An explanation which is not given in this article, is that the pelvic floor is a part of an extension chain, primarily created by the m. extensor hallucis longus, m. biceps femoris, m. obturatorius internus, m. rectus abdominus, m. obliquus internus and externus, m. latissimus dorsi and the cervical flexor muscles. Activation of the extensor muscle chain, which happens frequently during sports, will put the pelvic floor under tension and therefore increase muscle activity.
An evident limitation of this study is that only white women who gave birth were included, which makes the results not representative for all women.
In short: there is still a long way to go for all physiotherapists to motivate our patients in performing moderate to intense physical activity, for a minimum of 150 minutes per week (spread over several days).