**6. Acknowledgments**

Faculdade de Educação Física- Universidade Estadual de Campinas- UNICAMP. Maria Helena Baena de Moraes Lopes. Maria da Consolação G.C.F. Tavares. Artur Paulo Caetano. Nicholas Silva Caetano. Andrea Castillo.

#### **7. References**

82 Urinary Incontinence

floor reactions during several physical activities and also during long term physical practice. Researches aiming to identify pelvic floor reactions to different mid and long term physical

Through our project and a proposal of physical activities (Aletha et al., 2009b) which included PFM training and strengthening exercises, we were able to point out that, besides the results showing a reduction of incontinence complaints and an improvement in the participants' body image, it is also possible to create strategies to be used by Physical Education professionals who train incontinent women. A systematic and integrated physical activity program as described in the previous item allow incontinent women to get a better health and quality of life perception, specially towards their own body image and towards a decrease in incontinence complaints, with a reduction of the amount and frequency of

Unfamiliarity with the connection between urinary incontinence and physical activity creates a gap in the education of Physical Education professionals and, hence, in their teaching practice. Leaving PFM exercises out of global exercising programs does not seem reasonable, as those muscles are part of every woman's functional activity and deserve attention. Coaches and physical trainers should encourage female athletes and non-athletes to contract the pelvic muscles while exercising because women are quite unlikely to think about it without guidance. Every woman, athlete or not, must stimulate these muscles so as to identify and contract them during gym classes and aerobic exercises, in order to prevent or reduce urinary incontinence and improve bladder control. The coach should always ask his/her athletes about incontinence symptoms resulting from strong-effort and high-impact exercises so as to contribute with strategies which help solve or minimize the problem. Moreover, the coach should help his/her student or athlete become aware of urinary incontinence and of its connection with high impact exercises and sports and make them realize how important it is to strengthen the muscles responsible for female urinary continence. Hence, once they have a coach or instructor who is prepared to discuss these issues, students and athletes will find it safe to share their incontinence first symptoms or existing problems with them. These actions can change physical activity and sports practice into a supporting and even preventing intervention in the treatment of urinary incontinence, helping to reduce prevalence rates and to prevent incontinent women to quit physical activities, making sure they enjoy the benefits of such practice. Controlled studies carried out on future researches are needed, in order to investigate how physical activities, specific PFM exercises included, can bring benefits people with urinary incontinence in the mid and

Faculdade de Educação Física- Universidade Estadual de Campinas- UNICAMP.

exercises should be carried out in the future.

urinary leaking.

long run.

**6. Acknowledgments** 

Artur Paulo Caetano. Nicholas Silva Caetano.

Andrea Castillo.

Maria Helena Baena de Moraes Lopes. Maria da Consolação G.C.F. Tavares.


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**1. Introduction** 

Sahyoun, et al., 2001).

**2. Background** 

research related to elderly women and UI in LTC.

**6** 

*Canada* 

**Elderly Women and Urinary** 

Catherine MacDonald *Saint Francis Xavier University* 

**Incontinence in Long-Term Care** 

The prevalence of urinary incontinence (UI), although difficult to define due to underreporting, is estimated to affect over 13 million Americans, and greater than 50% of residents residing in long-term care (LTC) facilities (Bennet, 2008; Earthy & Nativ, 2009; Parker, 2007). It has been estimated that the cost of UI in Canadian LTC facilities is approximately \$3000.00 to \$10,000.00 per year for each resident experiencing UI (Earthy & Nativ, 2009). The Canadian Continence Foundation (2005) reported that one in four middleaged and older women are affected by UI. By the year 2050, the number of women likely to experience UI will increase by 46% (Romanzi, 2010). The increasing prevalence of UI in long term-care facilities from 55% to 65% over the past 10 years is alarming, and requires careful consideration by healthcare providers and policy-makers (MacDonald & Butler, 2007;

UI is a multidimensional healthcare issue that should be viewed from various perspectives and contexts, as a condition requiring operational, clinical, strategic, and interdisciplinary focus (Klusch, 2003). However, the current state of the knowledge maintains that much of the existing literature continues to explore UI from the contexts of the medicalization of UI, the physical and economic burdens of UI, the marginalization of elderly women experiencing UI in long- term care, and healthcare providers' attitudes, approaches, and strategies to managing UI in LTC. There were few references found that discussed how elderly women managed their UI, and the effects of UI on the quality of life (QoL) from the women's lived experiences. To date the psychosocial effects of urinary incontinence for elderly women has received minimal attention in the current research literature. Physiological complications and the implications for symptom management of UI are the predominant research issues being addressed. The following chapter presents an account of the current state of knowledge with each of the aforementioned topics discussed in relation to elderly women in LTC. The chapter will begin by defining UI, and end with a necessary discussion of healthcare practices, education, and

UI is a prevalent health issue adversely affecting the quality of life, well-being and psychosocial aspects of elderly women's lives residing in LTC (Bradway et al., 2010;

WHO/FIMS (1995). Committee on Physical Activity for Health: Exercise for health. *Bullettin of the World Health Organization: The International Journal of Public Health,* Vol. 73, pp. 135-136, ISSN: 0042-9686.
