Investigation of core muscle strength, endurance and balance parameters in women with urinary incontinence

Urinary incontinence (UI) is defined as the involuntary loss of urine that occurs outside the individual's control and negatively affects both hygiene and social life. Research indicates that individuals with UI experience decreased core muscle strength and endurance, which may also lead to changes in balance parameters. Therefore, the aim of this study was to investigate core muscle strength, endurance, and balance parameters in women with UI, taking the type of UI into consideration. This study was conducted between January 2025 and April 2025 at the Urogynecology Clinic of Başakşehir Çam and Sakura City Hospital in Istanbul, with patients diagnosed with UI by a specialist physician. A total of 32 participants were included. All participants were administered a demographic assessment form; the International Physical Activity Questionnaire-Short Form (IPAQ-SF) to assess physical activity level; the Pelvic Floor Distress Inventory (PFDI-20) and all of its subscales to evaluate the severity of symptoms associated with pelvic floor distress; urodynamic measurement; a pad test to assess the severity of UI; a perineometer device to evaluate pelvic floor muscle (PFM) strength; the Sahrmann five-level core stabilization test and the Stabilizer Pressure Biofeedback Unit to assess core muscle strength; McGill's Trunk Endurance Tests for core endurance; and the Y Balance Test to assess balance. In our study, both a comparison of all individuals with UI against normative data of healthy women was conducted, and the participants were also analyzed according to their UI types. When UI types were examined, 23.3% of the participants had stress urinary incontinence (SUI), 23.3% had urge urinary incontinence (UUI), 43.3% had mixed urinary incontinence (MUI), and 10% were classified under other UI types. According to the findings of our study, core muscle strength, endurance, and balance parameters were found to be significantly lower in women diagnosed with UI compared to healthy women (p<0.05). In addition, the level of discomfort associated with UI was significantly higher in the MUI group compared to the SUI and UUI groups (p<0.05). A statistically significant difference was observed in voided volume between the SUI and MUI groups (p=0.010), as well as between the UUI and MUI groups (p=0.020). Finally, pelvic floor muscle strength was significantly higher in individuals with SUI compared to those with UUI (p=0.032). In conclusion, our study found that core muscle strength, endurance, and stability are reduced in women with UI, which negatively affects balance. These findings highlight the necessity of a multidisciplinary approach in the rehabilitation process of UI—including pelvic floor muscle training (PFMT), exercises to improve core muscle endurance, balance exercises, and modifications in general physical activity and lifestyle. Key words: Urinary incontinence, Core Muscle Strength, Endurance, Balance, Pelvic Floor Muscles.