General exercise as good as yoga for female urinary incontinence

A study which compared pelvic floor yoga to general muscle conditioning found that yoga was only slightly better at relieving bladder issues.

Yoga has been recommended for years to treat or prevent health conditions that are associated with aging, such as urinary incontinence, but there’s been little data to back it up.

Now, a study led by the University of California, San Francisco has found that pelvic floor yoga is not superior to a general exercise programme at reducing urinary incontinence in older women.

The research, published in Annals of Internal Medicine, showed that regular muscle stretching and strengthening exercises could improve urinary incontinence symptoms almost as much as yoga.

“The results suggest that women who pursue specialised training in pelvic yoga for their bladder problems could see similar improvements if they instead dedicated the same amount of time and effort to other, general physical conditioning exercise,” said first author Alison J. Huang, a UCSF professor of medicine, epidemiology and biostatistics and urology.

“Some women may still prefer yoga because of its other potential mind-body benefits,” she said. “But because yoga tends to require specialised instruction and props, it may be easier and less expensive to engage in other forms of physical activity or exercise.”

Studies have shown that urinary incontinence is a common ailment affecting nearly half of midlife and older women. The condition can lead to depression, social isolation and functional decline.

Pelvic yoga, which has become popular among women of all ages, is designed to improve pelvic health problems such as incontinence, pelvic pain, or overactive bladder that can worsen due to childbirth, menopause or ageing. But there’s been little rigorous research to evaluate its effectiveness, and many clinicians have been skeptical that yoga provides special benefits.

The LILA study (Lessening Incontinence through Low-Impact Activity) involved 240 women 45 to 90 in California who were experiencing urinary incontinence at least daily, were not using other treatments for incontinence, and not already participating in yoga or organised muscle strengthening activities.

They were randomly assigned for three months either to the pelvic yoga programme of group classes twice a week and individual practice once a week, or to a physical conditioning programme of general muscle stretching and strengthening with an equivalent amount of group classes and individual practice.

The authors found that women in the yoga group reported more than a 60 per cent decrease in the average frequency of incontinence. However, women in the general conditioning programme also reported nearly a 50 per cent improvement in their symptoms.

The authors concluded that both groups experienced a “clinically meaningful” improvement in their incontinence, and that yoga was not clearly better, although it resulted in modestly greater improvement in some more specialised types of urinary symptoms.

“The results may provide support for a shift in thinking about treatment approaches for incontinence in older adults,” Huang explained.

“Rather than focusing primarily on treatments that target the bladder or pelvic floor, perhaps we should focus on strategies that improve our overall physical function as we age.”