Ron, Nicole J.

Background: Running often elicits stress urinary incontinence (SUI) in parous athletes. While cadence retraining improves running biomechanics, its impact on incontinence is unclear. This feasibility study assessed the implementation and preliminary effects of a 6-week cadence retraining program in parous female runners with SUI. Methods: A total of 8 participants with self-reported SUI and a preferred running cadence ≤ 170 steps/minute underwent treadmill testing before and after the intervention. The program involved a 6-week cadence retraining program using a Garmin Forerunner 55 watch. Feasibility was assessed across 6 domains. Running outcome measures included cadence and vertical oscillation. SUI outcome measures included the Questionnaire for Urinary Incontinence Diagnosis and Urinary Distress Inventory-6 scores. Paired t-tests were conducted (α = .05). Results: Following the 6-week program, feasibility outcomes supported the viability of study procedures and high adherence. Statistically significant increases in cadence ( P = .016) and decreases in vertical oscillation ( P = .019) and concomitant decreases in Questionnaire for Urinary Incontinence Diagnosis ( P = .013) and Urinary Distress Inventory-6 ( P = .042) scores were observed. Discussion: This study demonstrated the feasibility and acceptability of a 6-week cadence retraining program for parous runners with SUI. Given the growing movement to foster athleticism after pregnancy, these findings will appeal to physical therapists searching for acceptable treatment options for SUI in parous runners. Preliminary running mechanics and SUI symptoms warrant a larger randomized controlled trial. A power analysis estimated a sample size of 66 participants for a future full-scale efficacy study.

Purpose: This study examined if vertical bladder excursion during pelvic floor muscle (PFM) contraction, measured with transabdominal ultrasound (TAUS), improved following a single training session 0-5 days postpartum. It also assessed patient satisfaction with the training. Methods: 75 healthy, female volunteers within 0-5 days post-vaginal delivery were recruited during their inpatient postpartum stay. Participants completed one in-person session involving a standardized bladder filling protocol, TAUS imaging during PFM contractions, a PFM training session using TAUS as visual biofeedback, and a two-question post intervention survey. Vertical bladder base excursions were compared pre- and post- training between two groups: those whose bladder bases descended and those whose ascended during baseline contractions. A mixed model ANOVA with one between-group factor (baseline descenders vs. ascenders) and one within-group factor (pre- vs. post-training) analyzed the change in bladder lift. Patient satisfaction was assessed with Likert scales. Results: Mean vertical excursion increased from 0.12 cm (SD = 0.48) to 0.32 cm (SD = 0.33) post-training, which was statistically significant (p <.001, Cohens d = 0.767). Greater improvements were noted in those with a bladder base descent at baseline. All participants reported the experience to be helpful or very helpful and were satisfied or very satisfied. Discussion: Participants increased vertical bladder excursion during PFM contraction with TAUS biofeedback within a single session, especially those with baseline paradoxical bladder excursion and perineal trauma during delivery. Participants found the experience helpful and satisfying, suggesting TAUS biofeedback may be a useful tool in early postpartum PFM rehabilitation.

Background: Women with stress urinary incontinence (SUI) may have altered running mechanics and reduced hip muscle strength compared with women without SUI. Little research has examined running metrics and functional lower extremity strength of parous runners. Objective: To determine whether SUI severity correlates with running metrics and lower extremity muscle strength among parous women. Study Design: This was a cross-sectional observational study of 22 parous participants (mean age 39.8 years, with a mean of 3.4 pregnancies and 8.1-year interval since last delivery). Methods: Participants completed the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-UI), Urinary Distress Inventory-6 (UDI-6), Colorectal-Anal Distress (CRAD) Inventory-8, and Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), and Questionnaire for Urinary Incontinence Diagnosis (QUID) and provided demographic, relevant running, and obstetric/gynecologic history information. After a brief warm-up, participants completed 30-second single-leg sit-to-stand tests bilaterally and a standardized 10-minute treadmill run with pod cadence assessment. Pearson-product moment correlation coefficients were calculated (α = .05). Results: Prolonged ground contact times were associated with higher ICIQ-UI SF (r= 0.523, P= .015), POPDI-6 (r= 0.694, P< .001), and UDI-6 scores (r= 0.577, P= .006), while lower cadences were associated with higher POPDI-6 (r=−0.550, P= .010) and UDI-6 scores (r=−0.444, P= .044). Conclusions: Parous female runners with more severe SUI and prolapse symptoms demonstrate altered running mechanics characterized by prolonged ground contact times and slower cadences.