Incidence of Stress Incontinence in High School Females
Megan Baker, SPT; Sophie DeHaven, SPT; Caitlin Dellar, SPT; Abbey Gebhardt, SPT, CSCS; Kayla Keckeisen, SPT, CSCS
Faculty Mentors: Jean Hiebert, PT, Ph.D.
Purpose: Stress incontinence is an involuntary loss of urine due to abdominal pressure on the bladder during physical activity such as coughing, sneezing, or jumping. It has typically been considered a problem associated with normal female aging, especially those who have given birth vaginally. However, stress incontinence is also reported to occur more often in middle-aged and college-aged females who participate in sports. This is believed to be due to increased abdominal pressures created from physical training and sports participation, suggesting athletes may benefit from exercises to prepare the pelvic floor muscles to offset these increased pressures. Few studies have explored whether females participating in sports at the high school level also experience an increase in incontinence. Therefore, the purpose of this study was to compare the incidence of stress incontinence in high school females that do and do not participate in sports. This information will help to better understand when pelvic floor muscle exercises should be introduced to athletes.
Number of Subjects: 42
Methods: A paper survey was distributed to 9th-12th grade students attending a Midwest all girls high school. The survey contained questions about activity level and sports involvement. Respondents were asked to indicate the frequency and intensity of leakage during everyday activities (e.g., coughing, jumping, laughing) as well as during sports participation. Surveys were excluded from analysis if subjects reported having diabetes mellitus, kidney disorders, more than one urinary tract infection, or muscle or bone injury affecting the ability to urinate.
Results: A total of 360 surveys were distributed, with 68 surveys returned. Fifteen surveys were eliminated due to missing parental or subject informed consent; another 11 were eliminated due to presence of exclusion criteria. Of the remaining 42 surveys, 18 (45%) subjects indicated urinary leakage at some time. Of those subjects reporting leakage, 12 (66.67%) reported playing sports. Thirty-three subjects reported participation in sports. Of these, 12 (36%) reported urinary leakage at some time, with two reporting leakage during actual participation in their sport (soccer and cheerleading).
Conclusions: Our study found 45% of all respondents (athletes and non-athletes) reported urinary leakage at some time, which is consistent with the reported ranges of stress incontinence in all women. Of the subjects who reported leakage, 66% played sports. This is consistent with previous results indicating sports participation is associated with increased incontinence. The 17% incidence of incontinence found in our high school female athletes is lower than reported for college athletes, possibly due to differences in high school versus college level training programs.
Clinical Relevance: Though the incidence of incontinence was higher in athletes versus non-athletes, our finding of incontinence in 45% of all high school females suggest all females may benefit from physical therapy interventions at an early age to strengthen the pelvic floor musculature and decrease the occurrence of incontinence.
Acknowledgement: We would like to thank the school administrators who made this research possible and the girls and parents who participated in the study.
Megan Baker, SPT; Sophie DeHaven, SPT; Caitlin Dellar, SPT; Abbey Gebhardt, SPT, CSCS; Kayla Keckeisen, SPT, CSCS
Faculty Mentors: Jean Hiebert, PT, Ph.D.
Purpose: Stress incontinence is an involuntary loss of urine due to abdominal pressure on the bladder during physical activity such as coughing, sneezing, or jumping. It has typically been considered a problem associated with normal female aging, especially those who have given birth vaginally. However, stress incontinence is also reported to occur more often in middle-aged and college-aged females who participate in sports. This is believed to be due to increased abdominal pressures created from physical training and sports participation, suggesting athletes may benefit from exercises to prepare the pelvic floor muscles to offset these increased pressures. Few studies have explored whether females participating in sports at the high school level also experience an increase in incontinence. Therefore, the purpose of this study was to compare the incidence of stress incontinence in high school females that do and do not participate in sports. This information will help to better understand when pelvic floor muscle exercises should be introduced to athletes.
Number of Subjects: 42
Methods: A paper survey was distributed to 9th-12th grade students attending a Midwest all girls high school. The survey contained questions about activity level and sports involvement. Respondents were asked to indicate the frequency and intensity of leakage during everyday activities (e.g., coughing, jumping, laughing) as well as during sports participation. Surveys were excluded from analysis if subjects reported having diabetes mellitus, kidney disorders, more than one urinary tract infection, or muscle or bone injury affecting the ability to urinate.
Results: A total of 360 surveys were distributed, with 68 surveys returned. Fifteen surveys were eliminated due to missing parental or subject informed consent; another 11 were eliminated due to presence of exclusion criteria. Of the remaining 42 surveys, 18 (45%) subjects indicated urinary leakage at some time. Of those subjects reporting leakage, 12 (66.67%) reported playing sports. Thirty-three subjects reported participation in sports. Of these, 12 (36%) reported urinary leakage at some time, with two reporting leakage during actual participation in their sport (soccer and cheerleading).
Conclusions: Our study found 45% of all respondents (athletes and non-athletes) reported urinary leakage at some time, which is consistent with the reported ranges of stress incontinence in all women. Of the subjects who reported leakage, 66% played sports. This is consistent with previous results indicating sports participation is associated with increased incontinence. The 17% incidence of incontinence found in our high school female athletes is lower than reported for college athletes, possibly due to differences in high school versus college level training programs.
Clinical Relevance: Though the incidence of incontinence was higher in athletes versus non-athletes, our finding of incontinence in 45% of all high school females suggest all females may benefit from physical therapy interventions at an early age to strengthen the pelvic floor musculature and decrease the occurrence of incontinence.
Acknowledgement: We would like to thank the school administrators who made this research possible and the girls and parents who participated in the study.