Web-Based Yoga-Pilates: A Prospective Cohort Study. Issue 2 (February 2023)

• Record Type: Journal Article
• Authors: Cramer, Meagan S.; Holland, Amanda; Boniface, Emily R.; Gregory, W. Thomas; Clark, Amanda; Cichowski, Sara
• Is Part Of: Urogynecology. Volume 29:Issue 2(2023)
• Page Start: 252
• Page End: 259
• Publication Date: 2023-02
• Subjects: stress urinary incontinence -- yoga -- Pilates -- rhabdosphincter; Pelvis -- Diseases; Pelvis -- Surgery; Urogynecology; Urogynecologic surgery; 616.6
• DOI: 10.1097/SPV.0000000000001285
• Languages: English
• ISSNs: 2771-1897

Abstract

Abstract : Importance: There are limited data to determine the change in severity, efficacy, and mechanism of action of yoga-Pilates in the treatment of stress urinary incontinence (SUI). Objectives: The primary objective was to evaluate the effect of an 8-week web-based home yoga-Pilates exercise program on SUI severity and to evaluate the potential mechanism of action through ultrasound examination of the urethral rhabdosphincter cross-sectional area. Study Design: This was a prospective cohort study of women with SUI. Participants underwent visits pre- and post-intervention, completed quality of life/severity surveys, and underwent pelvic examination and 3-dimensional transperineal ultrasonography to determine the urethral cross-sectional area. Pre- and post-intervention 24-hour voiding diaries were also collected. The intervention was an 8-week online yoga-Pilates video that tracked and prompted participation. Results: Sixty women completed the study; they were predominantly premenopausal (67%) and vaginally parous (65%) and had done yoga (76%) and/or Pilates (44%). Seventy-three percent performed the exercises ≥3 times per week. For the primary outcome, the International Consultation on Incontinence Questionnaire—Urinary Incontinence Short Form score improved from 9.5 (95% confidence interval [CI], 8.7–10.4) to 7.1 (95% CI, 6.3–7.9) ( P < 0.001). The median (interquartile range) number of incontinence episodes per 24 hours decreased from 1 (1–3) to 1 (0–1) ( P < 0.001). The Brink pelvic floor strength score improved from 7.1 (95% CI, 6.6–7.7) to 7.7 (95% CI, 7.2–8.2) ( P = 0.01). Eighty-three percent reported that they were "better" on Patient Global impression of Improvement. There were no significant changes in urethral measurements. Conclusions: Although it did not meet the minimal clinically important difference, this 8-week web-based yoga-Pilates exercise program improved SUI symptoms and decreased the number of incontinence episodes in women with SUI.