sdü tıp fak derg

Medical Journal of Süleyman Demirel University

2602-2109

Süleyman Demirel Üniversitesi

10.17343/sdutfd.1723093

Health Physics

Sağlık Fiziği

The Relationship Between Urinary Incontinence and Motor Symptoms in Patients with Stroke

https://orcid.org/0000-0002-6671-0238

Yaşar

Pınar

SÜLEYMAN DEMİREL ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ FAKÜLTESİ

https://orcid.org/0000-0002-3764-215X

Duray

Mehmet

SULEYMAN DEMIREL UNIVERSITY

https://orcid.org/0000-0001-9749-2467

Kutluhan

Süleyman

SULEYMAN DEMIREL UNIVERSITY

https://orcid.org/0000-0002-2042-4463

Yürekli

Vedat Ali

SULEYMAN DEMIREL UNIVERSITY

12 01 2025

32 4 291 298 06 19 2025 09 04 2025

1994

Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi

Objective: This study aims to evaluate the relationship between post-stroke urinary incontinence and the severity of spasticity, balance, and gait performance.Material and Method: This cross-sectional study was conducted with 46 patients with stroke. The Modified Rankin Scale (MRS) was used to determine the functional status of the participants. A 24-hour pad test was performed to assess urinary incontinence, and the Danish Prostate Symptom Score (DANN-PSS) was utilized to evaluate urinary function. Spasticity, as one of the motor symptoms, was assessed using the Modified Ashworth Scale (MAS), while balance and gait were evaluated through the Tinetti Balance and Gait Assessment.Results: The mean age of patients with urinary incontinence was significantly higher than that of those without incontinence (p

Stroke urinary incontinence spasticity balance gait

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

1. Suskind AM, Cawthon PM, Nakagawa S, et al. Urinary incontinence in older women: The role of body composition and muscle strength: From the health, aging, and body composition study. J Am Geriatr Soc 2017;65(1):42–50.

2. Wang S, Kang H, Wang Q, et al. Incidence and influencing factors of urinary incontinence in stroke patients: A meta-analysis. Neurourol Urodyn 2024;43(3):680–93.

3. Kohler M, Mayer H, Kesselring J, Saxer S. Urinary incontinence in stroke survivors – Development of a programme theory. J Clin Nurs 2020;29(15–16):3089–96.

4. Sadeghi MA, Hemmati S, Razavi SZE, Vahabizad F, Yekaninejad MS, Azadvari M. Prevalence and features of post-stroke urinary incontinence: A Retrospective cohort study. Arch Iran Med [Internet] 2023;26(5):234–40. Available from: https://doi.org/10.34172/aim.2023.36.

5. Arkan G, Beser A, Ozturk V. Experiences related to urinary incontinence of stroke patients: A qualitative descriptive study. J Neurosci Nurs 2018;50(1):42–7.

6. Tibaek S, Gard G, Klarskov P, Iversen HK, Dehlendorff C, Jensen R. Are activity limitations associated with lower urinary tract symptoms in stroke patients? A cross-sectional, clinical survey. Scand J Urol Nephrol 2009;43(5):383–9.

7. Bilir Kaya B. Role of gender on quality of life and functional status in stroke patients with urinary incontinance. South Clin Istanbul Eurasia 2019;30(1):77–82.

8. Thomas L, Coupe J, Cross L, Tan A, Watkins C. Interventions for treating urinary incontinence after stroke in adults. Cochrane Database Syst Rev 2019;2.

9. Afanasjeva B, Afanasjevas D, Beliaziūnas P, Macaitytė R, Balnytė R. The association between spasticity and urinary incontinence and impact on quality of life in patients v. J Med Sci 2019;7(9):1–10.

10. Hacker ML, Tomaras MC, Lea Sayce Dp, Ploucher S, Naik AG, Turchan M, et al. Prevalence of comorbid spasticity and urinary incontinence in residents of a long-term care facility. J Gerontol Nurs 2020;46(10):35–42.

11. Zhang Y, Wang Y-Z, Huang L-P, Bai B, Zhou S, Yin M-M, et al. Aquatic therapy improves outcomes for subacute stroke patients by enhancing muscular strength of paretic lower limbs without increasing spasticity: A randomized controlled trial abstract. Am J Phys Med Rehabil 2016;95(11):840–9.

12. Mahmoudzadeh A, Ansari NN, Naghdi S, Ghasemi E, Motamedzadeh O, Shaw BS, et al. Role of spasticity severity in the balance of post-stroke patients. Front Hum Neurosci 2021;15:1–8.

13. Lance JW. The control of muscle tone, reflexes, and movernent: Robert Wartenbeg lecture. Neurology 1980;30(12):1303–13.

14. Katoozian L, Tahan N, Zoghi M, Bakhshayesh B. The onset and frequency of spasticity after first ever stroke. J Natl Med Assoc [Internet] 2018;110(6):547–52. Available from: https://doi.org/10.1016/j.jnma.2018.01.008

15. Shin Y Il, Kim SY, Lee HI, Kim DY, Lee J, Sohn MK, et al. Association between spasticity and functional impairments during the first year after stroke in Korea: The KOSCO Study. Am J Phys Med Rehabil 2018;97(8):557–64.

16. Gunawardhana C. Post-Stroke Complications and prognostication. In: Guide to stroke rehabilitation for healthcare professionals. 2021. p. 20.

17. Li Y, Wang Q, Liu X, Hui R, Zhang Y-P. Effect of the physical rehabilitation program based on self-care ability in patients with acute ischemic stroke: A quasi-experimental study. Front Neurol 2023;14:1181651.

18. Koch G, Bonnì S, Casula EP, Iosa M, Paolucci S, Pellicciari MC, et al. Effect of cerebellar stimulation on gait and balance recovery in patients with hemiparetic stroke: A randomized clinical trial. JAMA Neurol 2019;76(2):170–8.

19. Akkoç Y, Bardak AN, Ersöz M, Yılmaz B, Yıldız N, Erhan B, et al. Post-stroke lower urinary system dysfunction and its relation with functional and mental status: a multicenter cross-sectional study. Top Stroke Rehabil [Internet] 2019;26(2):136–41. Available from: https://doi.org/10.1080/10749357.2018.1555389

20. Panfili Z, Metcalf M, Griebling TL. Contemporary evaluation and treatment of poststroke lower urinary tract dysfunction. Urol Clin North Am [Internet] 2017;44(3):403–14. Available from: http://dx.doi.org/10.1016/j.ucl.2017.04.007

21. Bizovičar N, Mali B, Goljar N. Clinical risk factors for post-stroke urinary incontinence during rehabilitation. Int J Rehabil Res 2020;Publish Ah:310–5.

22. Arkan G, Beser A, Ozturk V, Bozkurt O, Gulbahar S. Effects on urinary outcome of patients and caregivers’ burden of pelvic floor muscle exercises based on the health belief model done at home by post-stroke patients. Top Stroke Rehabil [Internet] 2019;26(2):128–35. Available from: https://doi.org/10.1080/10749357.2018.1552741

23. Li J, Zhang P, Wu S, Wang Y, Zhou J, Yi X, et al. Stroke-related complications in large hemisphere infarction: Incidence and influence on unfavorable outcome. Ther Adv Neurol Disord 2019;12:1–10.

24. O’Sullivan R, Karantanis E, Stevermuer TL, Allen W, Moore KH. Definition of mild, moderate and severe incontinence on the 24-hour pad test. BJOG An Int J Obstet Gynaecol 2004;111(8):859–62.

25. Yesil H, Akkoc Y, Karapolat H, Güler A, Sungur U, Evyapan D, et al. Reliability and validity of the Turkish version of the Danish Prostatic Symptom Score to assess lower urinary tract symptoms in stroke patients. NeuroRehabilitation 2017;41(2):429–35.

26. Choi S, Lee B-H. The correlations between fall experience, balance, mobility and confidence in persons with stroke. Phys Ther Rehabil Sci 2020;9(3):178–83.

27. Ağırcan D. Tinetti Balance and gait assessment’ in (Ti̇netti̇ Denge ve Yürüme Değerlendi̇rmesi̇ ) Türkçe’ye uyarlanmasi, geçerli̇li̇k ve güveni̇li̇rli̇ği̇. Pamukkale Üniversitesi; 2009.

28. Shang X, Fu Y, Jin X, Wang C. Association of overweight , obesity and risk of urinary incontinence in middle-aged and older women : A meta epidemiology study. Front Endocrinol (Lausanne) 2023;14:1220551.

29. Pizzi A, Falsini C, Martini M, Rossetti MA, Verdesca S, Tosto A. Urinary incontinence after ischemic stroke: Clinical and urodynamic studies. Neurourol Urodyn 2014;33:420–5.

30. Agapiou E, Pyrgelis E-S, Mavridis IN, Meliou M, Wimalachandra WSB. Bladder dysfunction following stroke: An updated review on diagnosis and management. Bladder 2024;11(1):e21200005.

31. Özden F, Özkeskin M, Sarı Z, Ekici E, Yüceyar N. Association of urinary incontinence with sensory-motor performance in women with multiple sclerosis. Int Urogynecol J [Internet] 2024;1–7. Available from: https://doi.org/10.1007/s00192-024-05854-9

32. Ucar AT, Senoz GBO, Açıkgöz M. What is the relationship between disability level, hip adductor spasticity, and incontinence in people with Multiple Sclerosis?-A Pilot Study. J Mult Scler Res 2024;4(3):73–8.

33. Smith MD, Coppieters MW, Hodges PW. Is balance different in women with and without stress urinary incontinence? Neurourol Urodyn 2008;27:71–8.

34. Ayu Feratywi, Anita Candra Dewi. Correlation between improved balance and decreased limb spasticity and improved muscle strength in Post-Stroke Hemiparesis. J Sport Phys Educ Stud 2024;4(1):01–6.

35. Khiabani RR, Mochizuki G, Ismail F, Boulias C, Phadke CP, Gage WH. Impact of spasticity on balance control during quiet standing in persons after stroke. Stroke Res Treat 2017;(6153714):1–9.