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Alternative Exercise Regimens for Stress Urinary Incontinence in Women: A Systematic Review and Meta-analysis.

Jie Hao1, Zixuan Yao2, Andréas Remis3

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Alternative exercises are effective for stress urinary incontinence, showing results comparable to pelvic floor muscle training. These regimens significantly outperform usual care, offering a viable, evidence-based option for women.

Keywords:
DysfunctionExercise therapyPelvic floorPhysiotherapyWomen’s health

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Area of Science:

  • Urology
  • Physical Therapy
  • Women's Health

Background:

  • Stress urinary incontinence (SUI) significantly impacts women's quality of life.
  • Pelvic floor muscle training (PFMT) is a common SUI management strategy.
  • Evidence on alternative exercise regimens for SUI requires synthesis.

Purpose of the Study:

  • To systematically review and meta-analyze the effectiveness of alternative exercise regimens for SUI.
  • To compare alternative exercises against PFMT and usual care/placebo.

Main Methods:

  • Comprehensive database search (MEDLINE, Cochrane, CINAHL, Embase, PubMed, Scopus) up to April 2025.
  • Included randomized controlled trials (RCTs) of alternative exercises (Pilates, yoga, etc.).
  • Random-effects meta-analysis used to calculate standardized mean differences (SMDs) for SUI severity and quality of life.

Main Results:

  • Fourteen RCTs with 797 women were analyzed; nine studies were good quality.
  • No significant difference in SUI severity or quality of life between alternative exercises and PFMT.
  • Alternative exercises significantly improved SUI severity (SMD -1.34) and quality of life (SMD -1.03) compared to usual care/placebo.
  • No adverse events were reported.

Conclusions:

  • Alternative exercise regimens are comparable in effectiveness to PFMT for SUI management.
  • These regimens offer significant benefits over usual care/placebo.
  • Alternative exercises represent viable, evidence-based options for women with SUI.