Login to Access Video or Poster Abstract: MP63-03
Sources of Funding: none

Introduction

Functional incontinence is recognized as leakage of urine associated with restrictions in mobility and / or cognition resulting in urinary incontinence (UI); however, it lacks a validated instrument to measure its presence and to quantify its severity. In orthopedics, the timed get up and go test (TGUG test) is a validated method to determine timed functional mobility. Functional UI needs to take into account actions including undressing and/ or transition to the seated position for toileting. The objective of this study was to extend the concept of the TGUG to incorporate actions required for continent toileting for measurement of functional continence status in the elderly.

Methods

A volunteer sample of community dwelling adult women with UI and controls. Subjects completed the TAM-U sequence of: sit to stand, walk 10 m, turn, return 10 m, turn to sit, undress sufficient to sit on the urodynamics chair and void. Initiation of voiding (uroflow start) ends the sequence. Test retest of the full sequence in triplicate, kinematic subsequences, International Physical Activity Questionnaires (IPAQ short form) Urogenital Distress Inventory 6, Colorectal Anal Distress Inventory 8 and Pelvic Organ Prolapse Distress Inventory scores were compared. Uroflow parameters and post void residual by ultrasound were completed.

Results

10 controls and 20 UI subjects completed the TAM-U, mean age 70 years range 55 to 85, BMI mean 30 kg/m2, history of reduced mobility due to arthritis in 15, hip fracture in 5. IPAQ scores included inactive, minimally active and HEPA active in subjects and minimally active and HEPA active in controls, UGDI scores ranged from 12 to 30 in subjects and 0 to 3 in controls. Prolongations in gait or undress-sit-void sequences were associated with UI. Mean voided volumes in controls were 253cc (range 190cc-340cc), mean Qmax 22 cc/s (range 19-38) all with continuous flow patterns compared to incontinent subjects (180cc (range 140-250cc), mean Qmax 18 cc/s (range 15-30), PVR mean 45 (range 0 to 70). Test re test correlations were 0.84 in controls and 0.78 in incontinent subjects.

Conclusions

The TAM-U was developed as a physical function assessment tool that incorporates the actions required for seated voiding in the elderly. It is reproducible within subjects and total speeds for completion were statistically different between cases and controls. Further development will include incorporation of mobility aids and examination of the influence of clothing and hand function on undressing for voiding as part of self-care in the elderly.

Funding

none