PMID- 31187552
OWN - NLM
STAT- MEDLINE
DCOM- 20200423
LR  - 20200801
IS  - 1520-6777 (Electronic)
IS  - 0733-2467 (Print)
IS  - 0733-2467 (Linking)
VI  - 38
IP  - 6
DP  - 2019 Aug
TI  - Behavioral therapy for urinary symptoms in Parkinson's disease: A randomized 
      clinical trial.
PG  - 1737-1744
LID - 10.1002/nau.24052 [doi]
AB  - AIM: Determine the efficacy of behavioral therapy for urinary symptoms in 
      Parkinson's disease. METHODS: Randomized trial of behavioral therapy compared 
      with control condition among adults (aged 54-85 years, 74% male, 10% Black/ 83% 
      White) with Parkinson's and greater than or equal to 4 incontinence episodes 
      weekly. Behavioral therapy included pelvic floor muscle exercises, bladder 
      training, fluid and constipation management. Both groups completed bladder diary 
      self-monitoring. Outcomes included diary-derived incontinence and ICIQ-overactive 
      bladder (OAB) score (range, 0-16) with bother and quality of life questionnaires 
      (higher scores = worse outcomes). RESULTS: Fifty-three participants randomized 
      and 47 reported 8-week outcomes including 26 behavioral therapy and 21 control. 
      Behavioral vs control participants were similar with respect to age (71.0 +/- 6.1 
      vs 69.7 +/- 8.2 years), sex (70% vs 78% male), motor score, cognition, mean weekly 
      incontinence episodes (13.9 +/- 9.6 vs 15.1 +/- 11.1) and OAB symptoms (8.9 +/- 2.4 vs 
      8.3 +/- 2.2). Weekly incontinence reduction was similar between behavioral 
      (-6.2 +/- 8.7) and control participants (-6.5 +/- 13.8) (P = 0.89). After multiple 
      imputation analysis, behavioral therapy participants reported statistically 
      similar reduction in OAB symptoms compared to control (-3.1 +/- 2.8 vs -1.9 +/- 2.2, 
      P = 0.19); however quality of life (-22.6 +/- 19.1 vs -7.0 +/- 18.4, P = 0.048) and 
      bother (-12.6 +/- 17.2 vs - 6.7 +/- 8.8, P = 0.037) improved significantly more with 
      behavioral therapy. CONCLUSION: Self-monitoring resulted in fewer urinary 
      symptoms; however, only multicomponent behavioral therapy was associated with 
      reduced bother and improved quality of life. Providers should consider behavioral 
      therapy as initial treatment for urinary symptoms in Parkinson's disease.
CI  - (c) 2019 Wiley Periodicals, Inc.
FAU - Vaughan, Camille P
AU  - Vaughan CP
AUID- ORCID: 0000-0001-6713-794X
AD  - Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Atlanta 
      VA Health System, Atlanta, Georgia.
AD  - Division of General Medicine & Geriatrics, Department of Medicine, Emory 
      University, Decatur, Georgia.
FAU - Burgio, Kathryn L
AU  - Burgio KL
AD  - Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, 
      Birmingham VA Health System, Birmingham, Alabama.
AD  - Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, 
      University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Goode, Patricia S
AU  - Goode PS
AD  - Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, 
      Birmingham VA Health System, Birmingham, Alabama.
AD  - Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, 
      University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Juncos, Jorge L
AU  - Juncos JL
AD  - Department of Neurology, Emory University, Atlanta, Georgia.
FAU - McGwin, Gerald
AU  - McGwin G
AD  - Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, 
      Birmingham VA Health System, Birmingham, Alabama.
AD  - Department of Epidemiology, University of Alabama at Birmingham, Birmingham, 
      Alabama.
FAU - Muirhead, Lisa
AU  - Muirhead L
AD  - Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Atlanta 
      VA Health System, Atlanta, Georgia.
AD  - Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia.
FAU - Markland, Alayne D
AU  - Markland AD
AD  - Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, 
      Birmingham VA Health System, Birmingham, Alabama.
AD  - Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, 
      University of Alabama at Birmingham, Birmingham, Alabama.
FAU - Johnson, Theodore M 2nd
AU  - Johnson TM 2nd
AD  - Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Atlanta 
      VA Health System, Atlanta, Georgia.
AD  - Division of General Medicine & Geriatrics, Department of Medicine, Emory 
      University, Decatur, Georgia.
LA  - eng
GR  - IK2 RX000747/RX/RRD VA/United States
GR  - UL1 TR000454/TR/NCATS NIH HHS/United States
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20190611
PL  - United States
TA  - Neurourol Urodyn
JT  - Neurourology and urodynamics
JID - 8303326
SB  - IM
MH  - Aged
MH  - Behavior Therapy/*methods
MH  - Constipation/therapy
MH  - Exercise Therapy
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Parkinson Disease/*complications/psychology
MH  - Pelvic Floor
MH  - Quality of Life
MH  - Treatment Outcome
MH  - Urinary Bladder, Overactive/etiology/therapy
MH  - Urinary Incontinence/etiology/psychology/therapy
MH  - Urologic Diseases/*etiology/psychology/*therapy
PMC - PMC6660386
MID - NIHMS1031230
OTO - NOTNLM
OT  - Parkinson's disease
OT  - behavioral therapy
OT  - overactive bladder
OT  - urinary incontinence
COIS- Conflicts of interest: The authors report no conflicts of interest
EDAT- 2019/06/13 06:00
MHDA- 2020/04/24 06:00
PMCR- 2020/08/01
CRDT- 2019/06/13 06:00
PHST- 2019/03/15 00:00 [received]
PHST- 2019/05/05 00:00 [revised]
PHST- 2019/05/13 00:00 [accepted]
PHST- 2019/06/13 06:00 [pubmed]
PHST- 2020/04/24 06:00 [medline]
PHST- 2019/06/13 06:00 [entrez]
PHST- 2020/08/01 00:00 [pmc-release]
AID - 10.1002/nau.24052 [doi]
PST - ppublish
SO  - Neurourol Urodyn. 2019 Aug;38(6):1737-1744. doi: 10.1002/nau.24052. Epub 2019 Jun 
      11.