Effect of an Exercise Programme for Reducing Abdominal Fat on Overactive Bladder Symptoms in Young Overweight Women
Abstract
Overactive bladder (OAB) occurs in 5% to 10% of young women aged 18 to 35 years. Well-known associations include being overweight and obesity.
Overweight refers to a body mass index (BMI) between 25 and 29.9. Body mass index is an indicator of body weight but does not distinguish between fat and muscle mass and can increase even when the body has more muscle mass.
It is believed that body fat percentage and abdominal visceral fat are significant parameters of overweight. Excessive fat tissue in the abdominal cavity of overweight women increases intra-abdominal intravesical pressure, which is a cause of OAB.
Regular physical exercise and other measures such as diet can prevent and/or reduce OAB in overweight women and can have a positive effect on several parameters of body composition. The effect of exercise for reducing overweight and OAB in younger women has not been sufficiently examined or supported by studies.
The aim of this study was to reduce symptoms of OAB through use of a 3-month exercise program in young overweight women with OAB. The study was conducted at an academic hospital in Slovakia between March and September 2018.
Participants were students selected from 2 universities who met criteria for inclusion. All were overweight and had OAB.
The mean age of patients was 26.8 years. A body composition analyzer was used to assess skeletal muscle mass (kilogram), body fat mass, body fat percentage (percent), visceral fat area (square centimeter/level), and the waist circumference.
Overactive bladder symptoms and their intensity were assessed using a 3-day voiding diary and the Overactive Bladder Questionnaire and the Patient Perception of Intensity of Urgency Scale. The following training elements were included in the intervention: (1) aerobic training using a stationary bicycle, (2) warm-up stretching of muscles by slow and controlled movements, (3) strength training for reduction of abdominal fat, and (4) static stretching of lower limbs and abdominal muscles.
The control group did not undergo the exercise program but was evaluated after 12 weeks. Differences between the experimental and control groups were assessed preintervention and postintervention.
Among 93 women randomized, 23 did not complete the exercise program, leaving 70 for the final analysis: 34 in the treatment group and 36 in the control group. After training, significant differences in OAB symptoms favored the treatment group: the voiding diary (number of voiding/24 hours, nocturia, mean voided volume; treatment vs control group [baseline, 9.1 ± 0.3 vs 8.6 ± 0.3; final, 6.9 ± 0.2 vs 8.1 ± 0.2; P < 0.0001]) and mean voided volume per 24 hours (milliliter; treatment vs control group [baseline, 154.2 ± 9.1 vs 162.2 ± 9.3; final, 201.3 ± 9.3 vs 164.1 ± 9.6; P < 0.0001]) with a large effect size.
Body composition evaluation also showed significant differences favoring the treatment group: reduction of BMI, body weight, body fat percentage, visceral abdominal fat, and waist circumference (P < 0.0001), with a large effect size. These data show that after the 12-week PRAF exercise programs, body composition analysis reveals significant differences favoring the treatment group: reduction of BMI, body weight, body fat percentage, visceral abdominal fat, and waist circumference.
Similarly, there is a reduction in OAB symptoms objectively confirmed favoring the treatment group. Limitations of the study include loss of follow-up for 23 participants that did not complete the exercise program, lack of a strict controlled supply of calories in both groups, and no recommendation of a specific diet for either group.