The proposed project builds on our research on the effect of exercise on the circumvaginal muscles (CVM). Here the effect of clinical interventions (exercise and biofeedback) on lower urinary tract dysfunctions in aging women will be studied.
The specific aims are: 1. To describe variation in the dynamic characteristics of the CVM attributable to intraindividual variation in normal women. 2. To refine the CVM exercise intervention by determining in number of CVM contractions per exercise session needed to obtain significant improvement in the dynamic characteristics of the CVM. 3. To evaluate the effect of a CVM exercise intervention on genuine stress urinary incontinence (SUI). 4. To evaluate the effect of a CVM biofeedback intervention on sensory urgency. In the analysis of - each aim the variables maximum pressure and contracton area will be used; these variables taken form pressure tracings of the CVM are proven optimal variables. In the intervention studies bladder records and urodynamic tests will be used also. The clinical interventions will be tested with repeated measures designs in which repeated measurements are taken at baseline, after a control period and after the treatment period. Baseline measurements will be used to describe characteristics of study groups and will be used as covariates in the analysis when feasible. Consistent, careful research on the CVM will result in straightforward, teachable clinical interventions that can be implemented by women in any setting. Our efforts are directed toward enchancing the individuals control over continence mechanisms, thereby forstalling or preventing incontinence requiring expensive and invasive treatment.
