Strong Desire to Void and Balance in Older Women With Overactive Bladder (SURFACE)

April 11, 2024 updated by: Assistance Publique - Hôpitaux de Paris

Is Strong Desire to Void an Equivalent of Cognitive Task Affecting Balance in Older Women With Overactive Bladder?

Falls have multifactorial etiologies in older people. Lower urinary tract symptoms (LUTS) are one of those, with an increase prevalence over years (30% of people over 75 years old have overactive bladder [OAB]). Previous studies showed that older women with OAB with or without urinary incontinence (UI) are prone to have gait disorders (decrease of gait speed and step width and increase of number of step). Besides UI, it is more likely the strong desire to void (SDV) that seems to impact gait and balance control. In older women with UI, balance on stabilometric parameters have been affected with an increase of the center of pression (COP) sway range, COP area and rambling trajectory. SDV seems to act like an additional cognitive task. A similar and increased reaction time has been observed in comparing with a distracting task in healthy volunteers. In older people who are susceptible to distracting task, SDV may alters balance and gait.

The primary objective of this prospective study is to assess the impact of SDV on stabilometric parameters (center of foot pressure (COP) area, the distance travelled made by COP, the mean X-axis displacement and the mean Y-axis displacement) compared to the "empty bladder" condition.

The secondary objectives are to assess the impact of a cognitive task (verbal fluency) on stabilometric parameters in comparison with the "no cognitive task condition" and the "SDV condition"; to assess the impact of "SDV condition" on balance and gait clinical evaluation (Timed up and go test, unipedal stance test, Berg scale, 10m walking speed, 5 chair stand) Thus, showing that SDV may impact balance in geriatric population will lead to the importance to identify and LUTS as potential fall risk factor in order to decrease falls incidence in this population.

Study Overview

Detailed Description

Falls have multifactorial etiologies in older people. Lower urinary tract symptoms (LUTS) are one of those, with an increase prevalence over years (30% of people over 75 years old have overactive bladder [OAB]). Previous studies showed that older women with oAB with or without urinary incontinence (UI) are prone to have gait disorders (decrease of gait speed and step width and increase of number of step). Besides UI, it is more likely the strong desire to void (SDV) that seems to impact gait and balance control. In older women with UI, balance on stabilometric parameters has been affected with an increase of the center of pression (COP) sway range, COP area and rambling trajectory. SDV seems to act like an additional cognitive task.

A similar and increased reaction time has been observed in comparing with a distracting task in healthy volunteers. In older people who are susceptible to distracting task, SDV may alters balance and gait.

The primary objective of this prospective study is to assess the impact of SDV on stabilometric parameters (center of foot pressure (COP) area, the distance travelled made by COP, the mean X-axis displacement and the mean Y-axis displacement) compared to the "empty bladder" condition.

The secondary objectives are assessing the impact of a cognitive task (verbal fluency) on stabilometric parameters in comparison with the "no cognitive task condition" and the "SDV condition"; and assessing the impact of "SDV condition" on balance and gait clinical evaluation (Timed up and go test, unipedal stance test, Berg scale, 10m walking speed, 5 chair stand) This prospective study will take place in a rehabilitation department during a 2hours-consultation. The eligible criteria are: women over 65 years old, with OAB with or without UI, able to walk without mobility equipment without neurologic pathology or spine surgery, without severe cognitive impairment (MMSE > 24) or legal protection, and who agree to be involved in the study. OAB was defined by urinary urgency, usually with urinary frequency and nocturia, with or without urgency urinary incontinence.

The included women will first have a standard urinary consultation in which comorbidities, treatments and urinary symptoms will be recorded. Participants will also have questionnaires on urinary symptoms (Urinary Symptom Profile and Incontinence Consultation Incontinence Questionnaires) and the Mini Mental Status Examination (assessing cognitive functions).

Then, participants will be evaluated on balance and gait clinical and instrumental parameters under "SDV" and "empty bladder" conditions. The order of these evaluations (SDV/empty bladder) is randomized by computer. The clinical evaluations are the Timed up and go test, the unipedal stance test, the Berg scale, the 10m walking speed test and the 5-chair-stand test. The stabilometry evaluation (recording the center of foot pressure (COP) area, the distance travelled made by COP, the mean X-axis displacement and the mean Y-axis displacement) will be on a force platform under 4 conditions: SDV with and without verbal fluency and empty bladder with and without verbal fluency.

The stabilographic parameters will be analyzed using a two-way repeated measures ANOVAs. The repeated factors are the SDV and empty bladder condition and with or without verbal fluency. Four testing combinations of these factors will be used: SDV/with verbal fluency, SDV/without verbal fluency, empty bladder/with verbal fluency and empty bladder/without verbal fluency. The ANOVA results will be used to calculate the F statistics for each main effect and interaction. The post-hoc comparisons will be performed using the Bonferroni test. The level of statistical significance was set in all tests at P≤0.05.

Thus, if we show that SDV may impact balance in geriatric population it will lead to the importance to identify and treat LUTS as potential fall risk factor in order to decrease falls incidence in this population.

Study Type

Observational

Enrollment (Actual)

19

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

      • Paris, France, 75012
        • Hôpital Rothschild

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

65 years and older (Older Adult)

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Community-dweeling women over 65 years old, with non-neurogenic OAB, with or without UI

Description

Inclusion Criteria:

  • women;
  • over 65 years old;
  • with OAB with or without UI;
  • able to walk without mobility aid; consent to participate in the study

Exclusion Criteria:

  • neurologic pathology; history of spine surgery;
  • cognitive impairment defined as a MMSE < 24;
  • legal protection

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
women over 65 years old with OAB
Community-dwelling women over 65 years old, with non-neurogenic OAB, with or without UI
Strong desire to void - cognitive task (verbal fluency)

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Stabilometry platform assesment
Time Frame: 1 day
The primary outcome is a composite criterion of 4 parameters, assessing changes in stabilometry platform between "strong desire to void" and "empty bladder" conditions. These 4 parameters are the center of foot pressure (COP) area, the distance travelled made by COP, the mean X-axis displacement and the mean Y-axis displacement. need for bladder emptiness).
1 day

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Clinical balance
Time Frame: 1 day
Comparison of the Timed up and go test results between the 2 conditions: "strong desire to void" and "empty bladder".
1 day
Gait assesment
Time Frame: 1 day
Gait assesment: 10m walking speed
1 day
cognitive task assesment
Time Frame: 1 day
cognitive task evaluation ( words per minute) during B3 compared to B0 ( absence of need for bladder emptiness).bladder" conditions.
1 day

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

May 26, 2021

Primary Completion (Actual)

July 21, 2022

Study Completion (Actual)

July 21, 2022

Study Registration Dates

First Submitted

April 29, 2021

First Submitted That Met QC Criteria

May 27, 2021

First Posted (Actual)

June 2, 2021

Study Record Updates

Last Update Posted (Actual)

April 12, 2024

Last Update Submitted That Met QC Criteria

April 11, 2024

Last Verified

April 1, 2024

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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