THE EFFECT OF BLADDER FULLNESS ON BALANCE
Day T, Kearney A, Matlack G, Miller A, Schultz K; and Hiebert JM
Department of Physical Therapy Education, Rockhurst University, Kansas City, MO
Purpose: The pelvic floor muscles contribute to the intra-abdominal pressure needed for control of the spine and pelvis. In addition, these muscles maintain bladder position and aid in preserving urethral closure. As the bladder fills, increased activity is needed by the pelvic floor muscles to prevent urine leakage. The purpose of this study was to determine the effect of bladder fullness on static and dynamic standing balance. Specifically, we investigated whether performance during these tests was different immediately after voiding or 30 minutes after drinking 500 ml of water.
Method: Seventeen women (average age 54 + 5.65 years) with no more than a slight feeling of stress incontinence at rest or with physical activity participated in this study. Subjects were excluded if they reported a history of neurological or orthopedic conditions affecting balance. The Biodex Balance System SD® was used to assess the subjects’ balance during static postural stability (PS) and dynamic limits of stability (LOS) tests. Participants performed the tests under two conditions: immediately after voiding (referred to as empty bladder) and 30 minutes after voiding and drinking 500 ml of water (referred to as full bladder). The test conditions were randomized among subjects. Bladder volume in milliliters was determined using the BVI-3000 BladderScan instrument (Verathon Inc.).
Results: A 2x2 repeated measures design to evaluate the relationship between full and empty bladder for postural stability revealed no significant difference. An analysis of variance was utilized to analyze the time needed to obtain each limits of stability position based upon bladder fullness. There was no significant difference in time to perform the individual limits of stability direction tests or total time needed to complete the tests in all directions. Although not significant, the full bladder group took longer when traveling from center outwards to any given direction and the full bladder group took less time to travel back to center from any given location.
Discussion: There was no significant difference in the times needed for directional trunk movements based upon bladder fullness when assessing dynamic balance. However, subjects with full bladders took longer overall to reach a target and less time overall when returning to center. This suggests the pelvic floor muscles were being challenged in their role of providing trunk control while simultaneously maintaining urethral closure.
Conclusion: Based upon our test conditions, bladder fullness did not affect the ability of the pelvic floor muscles to participate in both trunk control and urethral closure. We suggest further studies in which subjects ingest larger volumes of water and increase the time before testing after drinking.
Acknowledgments: St. Luke’s Hospital Physical Therapy Department for the use of their equipment and Sandy Gibson, PT and Amy Foley, PT, DPT for their advice and guidance.
Day T, Kearney A, Matlack G, Miller A, Schultz K; and Hiebert JM
Department of Physical Therapy Education, Rockhurst University, Kansas City, MO
Purpose: The pelvic floor muscles contribute to the intra-abdominal pressure needed for control of the spine and pelvis. In addition, these muscles maintain bladder position and aid in preserving urethral closure. As the bladder fills, increased activity is needed by the pelvic floor muscles to prevent urine leakage. The purpose of this study was to determine the effect of bladder fullness on static and dynamic standing balance. Specifically, we investigated whether performance during these tests was different immediately after voiding or 30 minutes after drinking 500 ml of water.
Method: Seventeen women (average age 54 + 5.65 years) with no more than a slight feeling of stress incontinence at rest or with physical activity participated in this study. Subjects were excluded if they reported a history of neurological or orthopedic conditions affecting balance. The Biodex Balance System SD® was used to assess the subjects’ balance during static postural stability (PS) and dynamic limits of stability (LOS) tests. Participants performed the tests under two conditions: immediately after voiding (referred to as empty bladder) and 30 minutes after voiding and drinking 500 ml of water (referred to as full bladder). The test conditions were randomized among subjects. Bladder volume in milliliters was determined using the BVI-3000 BladderScan instrument (Verathon Inc.).
Results: A 2x2 repeated measures design to evaluate the relationship between full and empty bladder for postural stability revealed no significant difference. An analysis of variance was utilized to analyze the time needed to obtain each limits of stability position based upon bladder fullness. There was no significant difference in time to perform the individual limits of stability direction tests or total time needed to complete the tests in all directions. Although not significant, the full bladder group took longer when traveling from center outwards to any given direction and the full bladder group took less time to travel back to center from any given location.
Discussion: There was no significant difference in the times needed for directional trunk movements based upon bladder fullness when assessing dynamic balance. However, subjects with full bladders took longer overall to reach a target and less time overall when returning to center. This suggests the pelvic floor muscles were being challenged in their role of providing trunk control while simultaneously maintaining urethral closure.
Conclusion: Based upon our test conditions, bladder fullness did not affect the ability of the pelvic floor muscles to participate in both trunk control and urethral closure. We suggest further studies in which subjects ingest larger volumes of water and increase the time before testing after drinking.
Acknowledgments: St. Luke’s Hospital Physical Therapy Department for the use of their equipment and Sandy Gibson, PT and Amy Foley, PT, DPT for their advice and guidance.