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Advances in Motion

Moderate Physical Activity Reduces Risk of Urinary Incontinence in Women

Journal

Originally published on Urology

Key findings

  • This study of 30,213 female participants in the National Health and Nutrition Examination Survey examined the relationship between physical activity and urinary incontinence (UI)
  • Even after adjustment for demographics and established risk factors for UI, physical activity was associated with a decreased likelihood of stress, urge and mixed UI
  • The relationship held for both recreational and workplace-related activity
  • The risk of UI was reduced at all activity levels, but moderate activity was most strongly associated

Two large U.S. population-based studies have found the risk of urinary incontinence (UI) is reduced in individuals who engage in physical activity or minimize a sedentary lifestyle. In contradiction, though, some studies indicate physical activity exacerbates stress UI.

To explore this discrepancy, Michelle M. Kim, MD, PhD, director of the Prostate Health Program in the Department of Urology at Massachusetts General Hospital, and colleagues examined multiyear data from a nationally representative sample of U.S. women. In Urology, they link moderate physical activity and greater time spent participating in moderate physical activity to a decreased likelihood of stress, urge and mixed UI.

Study Methods

The data source for the study was the National Health and Nutrition Examination Survey, which is administered in-person to 10,000 U.S. residents every year. The researchers included 30,213 women who participated between 2008 and 2018.

Physical activity was evaluated using the Global Physical Activity Questionnaire, which appraises work and recreational activity, and sedentariness. Activity was defined as vigorous if it causes large increases in breathing or heart rate for at least 10 minutes continuously and as moderate if it causes small increases for at least 10 minutes.

Prevalence of UI

A total of 16,541 women (55%) had UI of any type:

  • 23% reported stress UI
  • 23% reported urge UI
  • 8% reported mixed UI

Physical Activity and UI Relationship

In a multivariate model that accounted for factors well-known to be associated with UI, such as age, ethnicity, parity, diabetes and current smoking:

  • Stress UI—Risk declined with more minutes of moderate recreational activity (OR, 0.79; P=0.04)
  • Urge UI—Risk declined with more minutes of walking/biking (OR, 0.65; P=0.01) and more days of moderate recreational activity (OR, 0.66; P=0.02)
  • Mixed UI—Risk declined with more days of vigorous recreational activity (OR, 0.37)

Moderate-intensity workplace-related activity was associated with a decreased likelihood of UI of all types.

Counseling Patients

These findings add to the evidence that physical activity—whether at work or leisure—is a modifiable risk factor for the prevention and treatment of UI.

Patients can also be counseled that while the risk of UI was reduced at all activity levels, a significant negative association between stress UI and physical activity was seen only for moderate-intensity activities (both recreational and workplace).

21%
lower odds of stress incontinence in women with more minutes of moderate recreational activity

35%
lower odds of urge incontinence in women with more minutes of walking/biking

34%
lower odds of urge incontinence in women with more days of moderate recreational activity

63%
lower odds of mixed incontinence in women with more days of vigorous recreational activity

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