Urinary incontinence among competitive female Rope Skipping athletes: A cross-sectional study

Dobrowolski S L1, Pudwell J2, Harvey M2

Research Type

Clinical

Abstract Category

Female Stress Urinary Incontinence (SUI)

Abstract 369
Open Discussion ePosters
Scientific Open Discussion Session 21
Thursday 30th August 2018
13:20 - 13:25 (ePoster Station 6)
Exhibition Hall
Female Incontinence Pelvic Floor Quality of Life (QoL) Questionnaire
1. Queen's University, Department of Physical Medicine and Rehabilitation, Kingston, ON, Canada, 2. Queen's University, Department of Obstetrics and Gynaecology, Kingston, ON, Canada
Presenter
S

Sarah Lynn Dobrowolski

Links

Poster

Abstract

Hypothesis / aims of study
The purpose of this study is to be the first to determine the prevalence, impact and management practices of urinary incontinence (UI) among Rope Skipping (RS) athletes.
Study design, materials and methods
A cross-sectional observational research study was employed that included two survey questionnaires. Survey #1 (current athletes) – Competitive female RS athletes ages 13 years and older, attending the 2017 Rope Skipping Canada national championships received a questionnaire in their registration packages that was collected throughout the competition. The primary outcome, the overall prevalence of UI during RS, was determined by a simple yes-no question, “Do you leak urine during Rope Skipping activities?”. An 11-point Likert scale (0-10) was used to assess interference with RS activities:  “Overall, how much does leaking urine interfere with your Rope Skipping activities?” Quality-of-life was evaluated using the ICIQ-SF. An unvalidated sport-specific questionnaire inspired by the IIQ-7 was used to assess the prevalence and bothersomeness of UI for each RS event type (“not at all-0”, “slightly-1”, “moderately-2”, “greatly-3”). Data was collected on the timing of UI and its management while RS and UI risk factors. Survey #2 (retired athletes) – In order to determine whether UI contributed to athlete retirement from RS, retired female and male RS athletes were invited to complete an online questionnaire asking respondents to identify their reasons for retiring from RS. This questionnaire was created by listing the most common reasons that children and youth drop out of organized sport with the addition of UI as one option (1). The questionnaire was disseminated by Rope Skipping Canada, the national governing body for RS in Canada, via email and social media between May and August 2017.
Results
Survey #1 – 162 athletes were approached and 89 surveys were completed (55%). Results are reported as median (IQR). The median age was 16 years (14-20), and BMI of 21 kg/m2 (20-23). Subjects practiced RS 360 minutes/week (240-360), were mostly menarchal (88%), and nulliparous (93%). Seventy-five percent of athletes reported UI during RS. Among those incontinent during RS, 21% (14/67) indicated that the overall interference of UI with RS was moderate or greater (score of ≥ 4 on the interference question). The median ICIQ-SF score in incontinent athletes was 4 (3-6). Consecutive ‘double unders’ and ‘triple unders’ were associated with the greatest prevalence of UI during competition, 67% (36/54) and 86% (48/56) of respondents, respectively. Of the athletes reporting incontinence during these events 19% (10/54) and 48% (27/56) reported being affected moderately or greatly for ‘double unders’ and ‘triple unders’, respectively. Attrition from participation in either of these two events due to UI was 6% (4/67) in competition and 16% (11/67) in practice. When asked about timing of UI during RS events, 64% of respondents indicated that UI occurred in the middle rather than at the beginning or end of the RS events. Athletes managed their UI with containment products (38%), fluid limitation (20%) or by voiding before (72%), or between RS events (71%). Despite the significant impact of UI on some athletes, none were receiving treatment for it. Menstruating athletes were 8 times more likely to have UI than premenarchal athletes (95% CI 1.5 – 56). Survey #2 – Seventy-four females and 3 males completed the online questionnaire. Respondents participated in competitive RS for a median of 9 years (6-12). Only one female athlete (1%) identified that UI was one of several reasons for retiring from RS.
Interpretation of results
Similar to other high-impact sports such as trampoline, female RS athletes experience a very high rate of UI while participating in RS; 80% of female trampoline athletes, and 75% of female RS athletes are affected by UI (2). Such numbers diverge greatly from the overall prevalence of UI during physical exercise among women in the general population (25%) (3). The finding that some RS athletes are greatly affected by UI, yet none are receiving treatment for it may indicate that RS athletes are either uncomfortable to discuss or seek treatment for UI, or consider this symptom ‘normal’ and harmless. Therefore, RS organizations should provide education about UI epidemiology and its management during RS to their athletes, coaches and parents in order to reduce any associated stigma, discuss UI prevention and to encourage UI treatment where appropriate. Further, RS organizations may wish to consider modifying certain competitive events (e.g. triple unders) since many athletes are negatively affected, and some have already discontinued participating in these events due to UI. The low percentage of retired athletes who indicated that UI contributed to RS retirement should be interpreted with caution in light of a notable selection bias; respondents were long-standing RS athletes, rather than those who dropped out after short term RS participation. Therefore, it remains unknown whether UI is a barrier to participation in earlier stages of RS involvement, and future research should address this gap.
Concluding message
Similar to other high-impact sports, female RS athletes experience a very high rate of UI while participating in RS, which can lead to a decrease in quality of life and sport attrition. This research will help guide UI awareness, prevention, and management strategies for RS athletes, coaches, parents and organizations.
References
  1. Crane J, Temple V. A systematic review of dropout from organized sport among children and youth. Eur Phys Educ Rev. 2015;21(1):114-131.
  2. Eliasson K, Larsson T, Mattsson E. Prevalence of stress incontinence in nulliparous elite trampolinists. Scand J Med Sci Sport. 2002;12(2):106-110.
  3. Nygaard I, Girts T, Fultz NH, Kinchen K, Pohl G, Sternfeld B. Is urinary incontinence a barrier to exercise in women? Obstet Gynecol. 2005;106(2):307-314.
Disclosures
Funding Rope Skipping Canada Clinical Trial No Subjects Human Ethics Committee Queen’s University Health Sciences Research Ethics Board, clearance # 6020689 Helsinki Yes Informed Consent Yes
28/03/2024 10:24:35