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Open AccessArticle

Benefits of Physiotherapy on Urinary Incontinence in High-Performance Female Athletes. Meta-Analysis

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Section of Urology, Department of Surgery, University of Salamanca, 37007 Salamanca, Spain
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Department of Physiotherapy, University of Salamanca, 37007 Salamanca, Spain
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Section of Urology, Department of Surgery, University of La Laguna, 38200 Tenerife, Spain
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Multidisciplinary Renal Research Group of the Institute for Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain
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Healthcare Complex of Zamora, 49002 Zamora, Spain
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Urology Service of the University Hospital of Salamanca, 37007 Salamanca, Spain
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(10), 3240; https://doi.org/10.3390/jcm9103240
Received: 9 September 2020 / Revised: 5 October 2020 / Accepted: 7 October 2020 / Published: 10 October 2020
(This article belongs to the Section Nephrology & Urology)
Introduction: High performance female athletes may be a risk group for the development of urinary incontinence due to the imbalance of forces between the abdomen and the pelvis. Pelvic floor physiotherapy may be a useful treatment in these patients. Objectives: (1) To identify the scientific evidence for pelvic floor (PF) dysfunctions that are associated with urinary incontinence (UI) in high-performance sportswomen. (2) To determine whether pelvic floor physiotherapy (PT) corrects UI in elite female athletes. Materials and methods: Meta-analysis of published scientific evidence. The articles analyzed were found through the following search terms: (A) pelvic floor dysfunction elite female athletes; (B) urinary incontinence elite female athletes; (C) pelvic floor dysfunction elite female athletes physiotherapy; (D) urinary incontinence elite female athletes physiotherapy. Variables studied: type of study, number of individuals, age, prevalence of urinary incontinence described in the athletes, type of sport, type of UI, aspect investigated in the articles (prevalence, response to treatment, etiopathogenesis, response to PT treatment, concomitant health conditions or diseases. Study groups according to the impact of each sport on the PF: G1: low-impact (noncompetitive sports, golf, swimming, running athletics, throwing athletics); G2: moderate impact (cross-country skiing, field hockey, tennis, badminton, baseball) and G3: high impact (gymnastics, artistic gymnastics, rhythmic gymnastics, ballet, aerobics, jump sports (high, long, triple and pole jump)), judo, soccer, basketball, handball, volleyball). Descriptive analysis, ANOVA and meta-analysis. Results: Mean age 22.69 years (SD 2.70, 18.00–29.49), with no difference between athletes and controls. Average number of athletes for each study was 284.38 (SD 373,867, 1–1263). The most frequent type of study was case-control (39.60%), followed by cross-sectional (30.20%). The type of UI was most often unspecified by the study (47.20%), was stress UI (SUI, 24.50%), or was referred to as general UI (18.90%). Studies on prevalence were more frequent (54.70%), followed by etiopathogenesis (28.30%) and, lastly, on treatment (17.00%). In most cases sportswomen did not have any disease or concomitant pathological condition (77.40%). More general UI was found in G1 (36.40%), SUI in G2 (50%) and unspecified UI in G3 (63.64%). In the meta-analysis, elite athletes were found to suffer more UI than the control women. In elite female athletes, in general, physiotherapy contributed to gain in urinary continence more than in control women (risk ratio 0.81, confidence interval 0.78–0.84)). In elite female athletes, former elite female athletes and in pregnant women who regularly engage in aerobic activity, physiotherapy was successful in delivering superior urinary continence compared to the control group. The risk of UI was the same in athletes and in the control group in volleyball female athletes, elite female athletes, cross-country skiers and runners. Treatment with PT was more effective in control women than in gymnastics, basketball, tennis, field hockey, track, swimming, volleyball, softball, golf, soccer and elite female athletes. Conclusions: There is pelvic floor dysfunction in high-performance athletes associated with athletic activity and urinary incontinence. Eating disorders, constipation, family history of urinary incontinence, history of urinary tract infections and decreased flexibility of the plantar arch are associated with an increased risk of UI in elite female athletes. Pelvic floor physiotherapy as a treatment for urinary incontinence in elite female athletes, former elite female athletes and pregnant athletes who engage in regular aerobic activity leads to a higher continence gain than that obtained by nonathlete women. View Full-Text
Keywords: physiotherapy; urinary incontinence; high performance athletes physiotherapy; urinary incontinence; high performance athletes
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MDPI and ACS Style

Sorrigueta-Hernández, A.; Padilla-Fernandez, B.-Y.; Marquez-Sanchez, M.-T.; Flores-Fraile, M.-C.; Flores-Fraile, J.; Moreno-Pascual, C.; Lorenzo-Gomez, A.; Garcia-Cenador, M.-B.; Lorenzo-Gomez, M.-F. Benefits of Physiotherapy on Urinary Incontinence in High-Performance Female Athletes. Meta-Analysis. J. Clin. Med. 2020, 9, 3240. https://doi.org/10.3390/jcm9103240

AMA Style

Sorrigueta-Hernández A, Padilla-Fernandez B-Y, Marquez-Sanchez M-T, Flores-Fraile M-C, Flores-Fraile J, Moreno-Pascual C, Lorenzo-Gomez A, Garcia-Cenador M-B, Lorenzo-Gomez M-F. Benefits of Physiotherapy on Urinary Incontinence in High-Performance Female Athletes. Meta-Analysis. Journal of Clinical Medicine. 2020; 9(10):3240. https://doi.org/10.3390/jcm9103240

Chicago/Turabian Style

Sorrigueta-Hernández, Alba; Padilla-Fernandez, Barbara-Yolanda; Marquez-Sanchez, Magaly-Teresa; Flores-Fraile, Maria-Carmen; Flores-Fraile, Javier; Moreno-Pascual, Carlos; Lorenzo-Gomez, Anabel; Garcia-Cenador, Maria-Begoña; Lorenzo-Gomez, Maria-Fernanda. 2020. "Benefits of Physiotherapy on Urinary Incontinence in High-Performance Female Athletes. Meta-Analysis" J. Clin. Med. 9, no. 10: 3240. https://doi.org/10.3390/jcm9103240

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