Behavioral therapy for urinary symptoms in Parkinson's disease: A randomized clinical trial

Academic Article

Abstract

  • © 2019 Wiley Periodicals, Inc. Aim: Determine the efficacy of behavioral therapy for urinary symptoms in Parkinson's disease. Methods: Randomized trial of behavioral therapy compared with control condition among adults (aged 54-85 years, 74% male, 10% Black/ 83% White) with Parkinson's and greater than or equal to 4 incontinence episodes weekly. Behavioral therapy included pelvic floor muscle exercises, bladder training, fluid and constipation management. Both groups completed bladder diary self-monitoring. Outcomes included diary-derived incontinence and ICIQ-overactive bladder (OAB) score (range, 0-16) with bother and quality of life questionnaires (higher scores = worse outcomes). Results: Fifty-three participants randomized and 47 reported 8-week outcomes including 26 behavioral therapy and 21 control. Behavioral vs control participants were similar with respect to age (71.0 ± 6.1 vs 69.7 ± 8.2 years), sex (70% vs 78% male), motor score, cognition, mean weekly incontinence episodes (13.9 ± 9.6 vs 15.1 ± 11.1) and OAB symptoms (8.9 ± 2.4 vs 8.3 ± 2.2). Weekly incontinence reduction was similar between behavioral (−6.2 ± 8.7) and control participants (−6.5 ± 13.8) (P = 0.89). After multiple imputation analysis, behavioral therapy participants reported statistically similar reduction in OAB symptoms compared to control (−3.1 ± 2.8 vs −1.9 ± 2.2, P = 0.19); however quality of life (−22.6 ± 19.1 vs −7.0 ± 18.4, P = 0.048) and bother (−12.6 ± 17.2 vs − 6.7 ± 8.8, P = 0.037) improved significantly more with behavioral therapy. Conclusion: Self-monitoring resulted in fewer urinary symptoms; however, only multicomponent behavioral therapy was associated with reduced bother and improved quality of life. Providers should consider behavioral therapy as initial treatment for urinary symptoms in Parkinson's disease.
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    Digital Object Identifier (doi)

    Author List

  • Vaughan CP; Burgio KL; Goode PS; Juncos JL; McGwin G; Muirhead L; Markland AD; Johnson TM
  • Start Page

  • 1737
  • End Page

  • 1744
  • Volume

  • 38
  • Issue

  • 6