Comparison of lower urinary tract symptoms and quality of life in female patients with multiple sclerosis with and without exercise habits

Öz

Purpose: The aim of this study was to compare lower urinary tract symptoms (LUTS) and quality of life in female patients with
Multiple Sclerosis (MS) with and without exercise habits.
Methods: Forty-two female patients with MS were enrolled in the study. The MS patients were divided into two groups as those
with (n=20) and without exercise habits (n=22). The exercise habit was determined based on the presence of activities that
lasted more than 20 minutes per day at least 3 days a week during the last 3 months. LUTS were evaluated with International
Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms Questionnaire and quality of life was
assessed with King Health Questionnaire (KHQ).
Results: Women with MS with exercise habits had lower incontinence symptoms (p=0.009), the emotions (p=0.023) and the
severity (p=0.010) subgroup scores of the KHQ than women with MS without exercise habits. Storage (p=0.265) and voiding
(p=0.734) symptom scores, and the general health (p=0.462), the urinary problem (p=0.215), the role limitation (p=0.447),
the physical limitation (p=0.207), the social limitation (p=0.287), the personal relationships (p=0.128) and the sleep-energy
(p=0.478) subgroup scores of the KHQ were similar between the groups.
Conclusion: It was found that women with MS who had exercise habit experienced less incontinence symptoms and some
parameters of quality of life were better than women with MS and without exercise habit. These results showed that the exercise
habit in female MS patients may contribute to the improvement of incontinence symptoms and quality of life. 

Anahtar Kelimeler

• Multiple Sclerosis
• Urinary incontinence
• Exercise

Multiple sklerozlu egzersiz alışkanlığı olan ve olmayan kadın hastalarda alt üriner sistem semptomları ve yaşam kalitesinin karşılaştırılması

Öz

Amaç: Bu çalışmanın amacı Multiple Skleroz (MS) tanılı egzersiz alışkanlığı olan ve olmayan kadın hastalarda alt üriner sistem
semptomları (AÜSS) ve yaşam kalitesini karşılaştırmaktı.
Yöntem: Çalışmaya kırk iki MS tanılı kadın hastalar dahil edildi. Hastalar egzersiz alışkanlığı olanlar (n=20) ve olmayanlar
(n=22) olarak iki gruba ayrıldı. Egzersiz alışkanlığı, son 3 ay boyunca haftada en az 3 gün ve günlük 20 dakikadan uzun sürmüş
olan aktivitelerin varlığına göre belirlendi. AÜSS, Uluslararası İnkontinans Konsültasyon Sorgulama Ölçeği-Kadın Alt Üriner
Sistem Semptomları ölçeği ile ve yaşam kalitesi King Sağlık Anketi (KSA) ile değerlendirildi.
Bulgular: Egzersiz alışkanlığı olan MS’li kadınlarda egzersiz alışkanlığı olmayan MS’li kadınlara göre inkontinans semptomları,
KSA’nın duygular (p=0,023) ve ciddiyet (p=0,010) alt grup skorları daha azdı (p=0,009). Depolama (p=0,265) ve boşaltım
(p=0,734) semptom skorları, KSA’nın genel sağlık (p=0,462), idrar problemi (p=0,215), rol kısıtlaması (p=0,447), fiziksel
kısıtlılık (p=0,207), sosyal kısıtlılık (p=0,287), kişisel ilişkiler (p=0,128) ve uyku-enerji (p=0,478) alt grup skorları gruplar
arasında benzerdi.
Sonuç: MS tanılı egzersiz alışkanlığı olan kadınların egzersiz alışkanlığı olmayan kadınlara göre inkontinans semptomlarını
daha az yaşadığı ve yaşam kalitesinin bazı parametrelerinin daha iyi olduğu bulundu. Bu sonuçlar, MS tanılı kadın hastalarda,
egzersiz alışkanlığına sahip olmanın özellikle inkontinans semptomları ve yaşam kalitesinde iyileşmeye katkı sağlayabileceğini
göstermektedir. 

Anahtar Kelimeler

• Multipl Skleroz
• Üriner inkontinans
• Egzersiz

Kaynakça

1. 1. Reich DS, Lucchinetti CF, Calabresi PA. Multiple Sclerosis. N Engl J Med. 2018;378:169-180.
2. 2. DasGupta R, Fowler CJ. Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies. Drugs. 2003;63:153-166.
3. 3. Paisley S, Beard S, Hunn A, et al. Clinical effectiveness of oral treatments for spasticity in multiple sclerosis: a systematic review. Mult Scler. 2002;8:319-329.
4. 4. Irwin DE, Milsom I, Hunskaar S, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50:1306-1315.
5. 5. Abrams P, Cardozo L, Fall M, et al. The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Am J Obstet Gynecol. 2002;187:116-126.
6. 6. Kızılkaya Beji N, Özbaş A, Aslan E, et al. Overview of the social impact of urinary incontinence with a focus on Turkish women. Urol Nurs. 2010;30:327-334.
7. 7. Perera J, Kirthinanda DS, Wijeratne S, et al. Descriptive cross-sectional study on prevalence, perceptions, predisposing factors and health seeking behaviour of women with stress urinary incontinence. BMC Womens Health. 2014;14:1-7.
8. 8. Bouchard C, Shephard RJ, Brubaker PH. Physical activity, fitness and health. Med Sci Sports Exer. 1994;26:119.

9. 9. Qiu J, Lv L, Lin X, et al. Body mass index, recreational physical activity and female urinary incontinence in Gansu, China. Eur J Obstet Gyn R B. 2011;159:224-229.
10. 10. Lee AH, Hirayama F. Physical activity and urinary incontinence in older adults: a community-based study. Curr Aging Sci. 2012;5:35-40.
11. 11. Faleiro DJA, Menezes EC, Capeletto E, et al. Association of physical activity with urinary incontinence in older women: A systematic review. J Aging Phys Activ. 2019;27:906-913.
12. 12. Markland AD, Richter HE, Fwu CW, et al. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. J Urology. 2011;186:589-593.
13. 13. Halabchi F, Alizadeh Z, Sahraian MA, et al. Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC Neurol. 2017;17:1-11.
14. 14. Laukkanen R, Hynninen E. (Eds.). Guide for the UKK institute 2-km walking test. Tampere: UKK Institute;1993.
15. 15. Özer Kaya D, Naz Gürşan İ, Günay Uçurum S, et al. Düzenli fiziksel aktivite ve egzersiz alışkanlığı olan ve olmayan üniversite öğrencilerinin fiziksel uygunluklarının karşılaştırılması : Ön çalışma. İzmir Kâtip Çelebi Üniversitesi Sağlık Bilimleri Fakültesi Dergisi. 2020;5:249-254.
16. 16. Chattrakulchai K, Manonai J, Silpakit C, et al. Validation of the Thai version of the International Consultation on Incontinence Questionnaire-Female Lower Urinary Tract Symptoms (ICIQ-FLUTS). Int Urogynecol J. 2020;31:2603-2610.
17. 17. Uğurlucan FG, Yaşa C, Yüksel Özgör B, et al. Validation of the Turkish version of the ICIQFLUTS, ICIQ-FLUTS long-form, ICIQ-LUTS quality-of-life, and ICIQ-FLUTS sexual functions. Neurourol Urodyn. 2020;39:962-968.
18. 18. Kelleher CJ, Cardozo LD, Khullar V, et al. A new questionnaire to assess the quality of life of urinary incontinent women. Brit J Obstet Gynaec. 1997;104:1374-1379.
19. 19. Kaya S, Akbayrak T, Toprak Çelenay Ş, et al. Reliability and validity of the Turkish King's Health Questionnaire in women with urinary incontinence. Int Urogynecol J. 2015;26:1853-1859.
20. 20. Townsend MK, Danforth KN, Rosner B, et al. Physical activity and incident urinary incontinence in middle-aged women. J Urology. 2008;179:1012-1017.
21. 21. Hagovska M, Švihra J, Buková A, et al. Effect of an exercise programme for reducing abdominal fat on overactive bladder symptoms in young overweight women. Int Urogynecol J. 2020;31:895-902.
22. 22. Da Roza T, Brandão S, Mascarenhas T, et al. Urinary incontinence and levels of regular physical exercise in young women. Int J Sports Med. 2015;36:776-780.
23. 23. Peterson JA. Minimize urinary incontinence: maximize physical activity in women. Urol Nurs. 2008;28:351-356.
24. 24. De Nunzio C, Nacchia A, Cicione A, et al. Physical activity as a protective factor for lower urinary tract symptoms in male patients: A prospective cohort analysis. Urology. 2019;125:163-168.
25. 25. Virtuoso JF, Mazo GZ, Menezes EC. Urinary incontinence and perineal muscle function in physically active and sedentary elderly women. Braz J Phys Ther. 2011;15:310-317.
26. 26. The WHOQOL Group. The development of the World Health Organization quality of life assessment instrument (the WHOQOL). In Quality of Life Assessment: International Perspectives. Heidelberg: Springer Verlag; 1994:41-57.
27. 27. Coons SJ, Rao S, Keininger DL, et al. A comparative review of generic quality-of-life instruments. Pharmacoeconomics. 2000;17:13-35.
28. 28. Alphonsus KB, Su Y, D’Arcy C. The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complement Ther Med. 2019;43:188-195.
29. 29. Bulguroglu I, Guclu-Gunduz A, Yazici G, et al. The effects of mat pilates and reformer pilates in patients with Multiple Sclerosis: A randomized controlled study. NeuroRehabilitation. 2017;41:413-422.
30. 30. Fitz FF, Costa TF, Yamamoto DM, et al. Impact of pelvic floor muscle training on the quality of life in women with urinary incontinence. Rev Assoc Med Bras. 2012;58:155-159.
31. 31. Sarı D, Khorshid L. The effects of pelvic floor muscle training on stress and mixed urinary incontinence and quality of life. J Wound Ostomy Cont. 2009;36:429-435.
32. 32. Lúcio AC, Perissinoto MC, Natalin RA, et al. A comparative study of pelvic floor muscle training in women with multiple sclerosis: its impact on lower urinary tract symptoms and quality of life. Clinics. 2011;66:1563-1568.