Comparing the effectiveness of pelvic floor muscle training and acupuncture for the treatment of urinary incontinence and the impact on health-related quality of life for non-homebound women >50 years of age: A secondary analysis

Background: Urinary incontinence (UI) is a common, chronic health condition. In 2001, it was estimated 20 million Americans experience UI. Incontinence has been shown to negatively impact health-related quality of life (HRQoL).;Objectives: The aims of this study of community-dwelling women, ≥50 years of age were to: 1) compare the effectiveness PFMT and acupuncture in reducing urinary incontinence, 2) compare their impact on HRQoL, 3) compare subject satisfaction with progress following the intervention phase of each study, 4) compare the treatment burden of each intervention, and 5) examine the relationship between the changes in UI and HRQoL.;Method: This secondary analysis used data from two independent RCTs. One study examined the effectiveness of PFMT in reducing UI in homebound and non-homebound men and women age 60 years and older. The second examined the efficacy of acupuncture in treating UI in women ≥ 25 years.;Sample: Two-hundred fifteen women age 50 years were included in the analysis, 148 (69%) from the PFMT study and 67 (31%) from the acupuncture study.;Measures: Baseline and post-intervention bladder diaries provided data to calculate the reduction in urinary continence. Physical and Mental Health Component scores from the SF-36 (v1.0) were used to measure HRQoL. The Patient Satisfaction Questionnaire provided data regarding satisfaction with progress and treatment burden.;Results: After controlling for group differences, PFMT (M = 56.6%) was more effective than acupuncture (M = 26.0%, p = .01) in reducing UI. There were no significant differences in the changes in SF-36 component scores between the groups. A higher proportion of women in the PFMT group were satisfied with their progress than in the acupuncture group (p < .001). There were no significant differences in self-reported treatment burden, which was low in both groups. Reduction in UI did not contribute significantly to the variability in the SF-36 component scores.;Conclusion: PFMT was more effective in the short-term treatment of UI in this analysis and should continue to be recommended as first-line therapy for UI. There is not enough evidence at this time to support acupuncture for the treatment of UI in non-homebound women 50 years of age and older.