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Each year, falls among older adults have become a significant concern, often leading to hospitalizations or the inability to live independently on their own again. 

Unsurprisingly, one significant factor contributing to these falls is the urgency to reach the restroom, especially at night. This urgency can result in two unfortunate outcomes: functional incontinence, where individuals are unable to reach or use the restroom in time or falls that may occur in the rush to relieve oneself.

Even a senior who is usually cautious might get distracted when hurrying to the restroom, paying less attention to tripping hazards, slippery surfaces, and maintaining their balance. 

A recent study has shown that balance and walking require cognitive (or sensory) inputs. For young and healthy people, walking is automatic and doesn’t require conscious thought. However, as you age, your brain changes, and you require more cognitive inputs to maintain balance. When you have a distracting factor such as a full bladder, the risk of falling becomes even higher. 

While there are several ways to address this problem, physical therapy in managing urges to relive oneself is a promising approach to prevent functional incontinence and falls among older adults. Read on! 

What is functional incontinence? 

Functional Incontinence refers to a condition commonly experienced by older adults, where the individual is unable to reach the restroom in time or use it. This can occur because of difficulties with walking, balance, or navigating their environment, rather than a primary issue with bladder control. They may also struggle with removing clothing or accessing toilet facilities on their own.

Other primary causes include physical limitations like joint pain or muscle weakness and cognitive impairments like dementia. 

Physical Therapy Interventions for Functional Incontinence

How can physical therapy help manage functional incontinence in older adults? 

The ageing process can affect bladder control in various ways. As individuals grow older, their bladder capacity may decrease due to a loss of elasticity. Additionally, weakened pelvic floor muscles, responsible for urine control, are frequently observed in older adults. These changes often result in heightened urgency and frequency of urination, as well as an increased risk of functional incontinence and falls. It’s important to address these issues, and physical therapy can help you with just that. 

Here are four important and effective physical therapies to manage functional incontinence: 

Caring For Older Adults The Role of Physical Therapy in Managing Functional Incontinence

1. Pelvic floor muscle exercises

The pelvic floor muscles support the bladder and aid in urination. As people age, these muscles naturally weaken and lose some of their strength and tone. Over time, this can lead to decreased bladder control. 

Pelvic floor exercises, also known as Kegel exercises, specifically target and strengthen these muscles to help regain bladder control.

Doing Kegels is very simple! Just imagine yourself trying to stop urination mid-stream, the muscles you just flexed are your pelvic floor muscles. Now tighten these muscles for a count of three and relax them for a count of three. Repeat this 10-15 times, which makes a set. Do 3 sets a day. That’s it! Just make sure that you’re not tightening any other muscles or holding your breath during the exercise. 

2. Bladder training techniques

The main goal of bladder training techniques is to improve bladder control and reduce urinary frequency and urgency. Here are some bladder training techniques you should try:

  • Scheduled Voiding: Make a schedule for emptying the bladder, regardless of if you feel the urge to urinate or not. Start with shorter intervals between restroom visits, and gradually increase the time between toilet trips. 

  • Delayed voiding: When the urge to urinate arises, try to delay going to the restroom for a few minutes. This helps gradually increase bladder capacity and regain control over the urge. 

  • Double Voiding: After emptying the bladder, wait a few minutes and then attempt to urinate again. This ensures the bladder is completely emptied and prevents frequent trips to the toilet. 

3. Electrical stimulation therapy

Electrical stimulation therapy involves the use of electrical currents to stimulate the pelvic floor muscles to improve their function. The therapy can be tailored to the individual’s needs, with adjustments made to the intensity, frequency, and duration of the electrical stimulation.

4. Lifestyle modification strategies

Lifestyle management plays a crucial role in managing all kinds of urinary incontinence. Making simple adjustments and picking up simple, healthy habits can help relieve symptoms and improve bladder control.

  • Avoiding caffeine, alcohol consumption, and smoking: Start by reducing or eliminating caffeine and alcohol intake. These substances can irritate the bladder and increase urgency and frequency of urination. Quitting smoking is also important, as smoking can cause chronic coughing, which puts pressure on the pelvic floor muscles and can contribute to bladder control problems.

  • Weight management: Maintaining a healthy weight is another key aspect of lifestyle management. Excess weight can put additional pressure on the bladder and pelvic floor muscles, leading to urinary incontinence. If you are overweight, consider adopting a balanced diet along with regular exercises to achieve and maintain a healthy weight.

  • Dietary modifications: Some foods and beverages can irritate the bladder and worsen urinary incontinence symptoms. Spicy foods, citrus fruits, tomatoes, carbonated drinks, and artificial sweeteners are some bladder irritants known to worsen urinary incontinence symptoms in some individuals. 

  • Constipation management: Chronic constipation can contribute to urinary incontinence by putting pressure on the bladder and pelvic floor muscles. To maintain regular bowel movements, ensure you have a fibre-rich diet, drink plenty of water, and engage in regular physical activity.

  • Fluid management: Fluid management involves maintaining sufficient hydration, spreading out fluid intake throughout the day, avoiding excessive fluid consumption close to bedtime or before activities with limited restroom access, and opting for bladder-friendly fluids such as water. 

Treatments and therapies for incontinence is individualized for each person, and not every approach is effective for everyone. While some might see significant improvement with lifestyle modifications alone, some might find relief only with surgical procedures. But even if these physical therapy interventions prove ineffective, Friends Adult Diapers can still provide a thorough managementsolution! Friends Adult Diapers: 

  • Provide exceptional absorption that lasts up to 16 hours. 

  • Are designed to flawlessly conform to YOUR body, ensuring zero leaks, spills, and uncomfortable bunching.

  • Are equipped with side leak guards for foolproof protection against side leakage.

  • Are made without chlorine, latex, toxins, or harmful chemical fragrances.

  • Provide an array of options, including overnight, ultra-thin diaper pants, and pant-style and tape-style diapers, catering to all your needs and available in sizes ranging from S to XXL.

With Friends aapko, Azadi Mubarak! 

FAQs on Functional Incontinence:

1. What is functional incontinence, and how does physical therapy help manage it? 

Functional incontinence meaning – a type of incontinence where individuals have trouble reaching or using the restroom in time. Physical therapy helps in managing functional incontinence by addressing the underlying factors contributing to this condition. Through targeted exercises, mobility training, and functional assessments, physical therapists help individuals improve their physical capabilities, reduce falls risk, and enhance their ability to reach the restroom in a timely manner.

2. What are the common causes of functional incontinence, and how can physical therapy address these underlying issues?

Common causes of functional incontinence include mobility impairments, muscle weakness, cognitive decline, and environmental barriers. Physical therapy tackles these underlying issues through various means. For mobility impairments, therapists work on improving strength, balance, and coordination to enhance mobility and reduce the risk of falls. Muscle weakness is addressed through exercises targeting specific muscle groups, such as pelvic floor exercises, to improve bladder control. Cognitive decline may be managed through strategies to enhance awareness and prompt individuals to initiate timely restroom visits. Furthermore, physical therapists provide guidance on modifying the environment to optimize accessibility and safety.

3. What are some of the exercises and techniques used in physical therapy to manage functional incontinence?

Physical therapy employs a range of exercises and techniques to manage functional incontinence effectively. These may include pelvic floor muscle exercises, also known as Kegel exercises, which strengthen the muscles responsible for bladder control. Core stability exercises to improve overall strength and support for pelvic floor muscles. Additionally, techniques such as bladder training, timed voiding, and double voiding strategies can help individuals regain control over their bladder function.