Effects of Pelvic Floor Dysfunction versus Functional Mobility Limitations on Urinary Incontinence Post-Stroke – A Literature Review

Alyssa Sunga

Co-Presenters: Charlene Morales, Nicole Pula

College: College of Health Professions and Human Services

Major: DPT.PHYSTHERAPY

Faculty Research Mentor: Tucker, Jenna  Lee, John

Abstract:

Title: Effects of Pelvic Floor Dysfunction versus Functional Mobility Limitations on Urinary Incontinence Post-Stroke – A Literature ReviewAuthors: Alyssa Sunga, Charlene Morales, Nicole Pula, Department of Physical Therapy, Kean UniversityFollowing a cerebrovascular accident (CVA), urinary incontinence (UI) can be a common complication characterized by difficulty with bladder control, leading to involuntary urination. Various mechanisms are linked to post-stroke UI including dysfunction of the pelvic floor musculature and decreased functional mobility. The aim of this literature review is to explore the effects of pelvic floor dysfunction versus functional mobility limitations on the presence of poststroke UI.A literature search was conducted using PubMed, ScienceDirect, and ProQuest. Keywords included: "post-stroke", "urinary incontinence", "pelvic floor dysfunction", "functional mobility", "bladder dysfunction", and "CVA". Inclusion criteria were: (1) studies involving poststroke patients presenting with UI, (2) written in English, (3) peer reviewed, and (4) published after 2000. Exclusion criteria included: (1) not involving post-stroke patients, and (2) not investigating the occurrence of UI.A search yielded 12 articles, and 5 studies met all criteria: one prospective cohort study, two narrative reviews, and two cross-sectional studies. Four studies emphasized UI being of neurologic origin, leading to pelvic floor dysfunction. Of these 4, 1study noted that impaired functional status was also associated with UI occurrence, and another study highlighted cognitive deficits as a primary factor alongside bladder dysfunction. The remaining article found that the prevalence of UI was higher in participants with functional limitations.Findings suggest that the occurrence of post-stroke UI is more highly associated with pelvic floor dysfunction. Some studies propose that functional mobility limitations play a factor in the prevalence of UI, though not as the primary cause. Furthermore, this review revealed limitations in the literature, emphasizing the need for more robust studies to determine correlation.Identification of the primary mechanisms leading to UI can assist clinicians in developing effective prevention and treatment strategies. Based on findings, in post-stroke, it may be beneficial to perform early screening for pelvic floor muscle dysfunction and interventions targeting pelvic floor impairments to improve UI outcomes.Keywords: CVA, Urinary Incontinence, Limited Functional Mobility, Pelvic Floor Dysfunction