The Influence Of Kegel Exercise On Urine Incontinension Reduction In Elderly

The elderly is a period of time when various health problems influence their lives, in general, the elderly complaint about various kinds of symptoms that are felt due to the condition of body organs that have a setback. One of the health problems often suffered by the elderly is urinary incontinence. This needs a special attention along with the increasing elderly population in Indonesia. Urinary incontinence is the process of uncontrolled urinary discharge at an undesirable time regardless of frequency and amount, due to weak pelvic floor contraction which will cause social and hygienic problems of the sufferer. Kegel Exercise or Kegel Exercise is a gymnastic activity that aims to strengthen the pelvic floor muscles, especially the pubococcygeal muscles so that a woman can strengthen the urinary tract muscles and can cure the inability to hold urine urination/incontinence. The purpose of this study was to determine the effect of kegel training on decreasing urinary incontinence in the elderly lived in nursing home. This is a quasi-experiment research with the Pretest-Postest One Group approach. The population of this study were all elderly at Tresna Werdha Budi Mulia Nursing Home Ciracas in East Jakarta who had urinary incontinence. 23 samples were taken in nonrandom. Data were gathered using an observation instrument by conducting active observations and filling out the checklist about 24-hour urination filled directly by the elderly every day during the study. Data analysis used non-parametric statistics with Paired T-test or Wilcoxon Signed Rank Test. The results of the T-dependent test, it was found that P-value was 0,000 (p<0.05) which showed that there was an effect of kegel training on the frequency of urinary incontinence There is a significant difference between urinary incontinence before exercise and urinary incontinence as a Kegel exercise. The results of this study are expected to contribute, both for the elderly who live in nursing homes and for health service institutions and educational institutions as well as for the development of nursing science in providing nursing care for elderly who experience urinary incontinence.

Traditional Gymnastic Exercises for the Pelvic Floor Often Lead to Bladder Neck Descent – a Study Using Perineal Ultrasound

Background The aims of physiotherapy in stress incontinent women are to improve pelvic floor function and the continence mechanism including bladder neck support and urethral closure pressure. In Germany, traditional conservative treatment often includes gymnastic exercises with unclear effects on the bladder neck. The aim of this study was to sonographically assess bladder neck movements during selected exercises. Methods Fifteen healthy, continent women without previous vaginal births, who were able to voluntarily contract their pelvic floor muscels performed the shoulder bridge, the abdominal press, tiptoe and the Pilates clam exercises. The first set was performed without any additional instructions. During the second set directions were given to activate the pelvic floor before beginning each exercise and to maintain the contraction throughout the exercise. Bladder neck movement was measured on perineal ultrasound using a validated method with the pubic symphysis as a reference point. Results The median age of participants was 32 years, median BMI was 23. Eight women were nulliparous and seven had given birth to 1 – 2 children via caesarean section. When exercises were performed without voluntary pelvic floor contraction the bladder neck descended on average between 2.3 and 4.4 mm, and with pelvic floor contraction prior to the exercise only between 0.5 and 2.1 mm (p > 0.05 except for abdominal press p = 0.007). The Pilates clam exercise and toe stand stabilised the bladder neck most effectively. Discussion Bladder neck descent often occurs during pelvic floor gymnastic exercises as traditionally performed in Germany, and a voluntary pelvic floor contraction during the exercises does not necessarily prevent this.