Aim of the study was to explore association between device measured physical activity and stress urinary incontinence (SUI). We hypothesized that level of physical activity was lower in women reporting SUI compared to continent women.

The study use data from the HUNT4 study which is a cross-sectional study conducted in 2017-2019. Women >18 years in a community in Norway were invited. Only women >30 years were asked about continence status and eligible for this study. Primary outcome was SUI, assessed with a questionnaire. Level of physical activity was measured with two triaxial accelerometers, one placed on the thigh and one at the lower back (L3 level). Participants were encouraged to wear the accelerometers on seven consecutive days, and the participants movement and sedentary time was measured continuously. Level of physical activity was calculated as total daily physical activity and weekly moderate-vigorous physical activity measured with MET (metabolic equivalent).

A total of 11,062 women were included in the analysis. Mean age was 57 (±14) and 31.9 % reported SUI.
SUI women had lower level of daily physical activity compared to continent women (103 ± 37 vs. 109 ± 36 minutes) and less time with moderate-vigorous physical activity measured with MET-min/week (822 ± 633 vs. 940 ± 665). In a multivariable logistic regression analysis level of moderate-vigorous physical activity lower than recommended (<500 MET-min/week) were associated with increased risk of reporting SUI (OR 1.17 [1.04,1.31], p <0.001).

The strength of the present study is the use of accelerometers to assess physical activity. Our results support previous studies using self-reports of physical activity, thus strengthening the association between SUI and lower levels of physical activity. Although we cannot conclude on causality between SUI and sedentary behavior, physical inactivity is a major concern for public health.

We found that women reporting SUI in general were less physically active and fewer women had weekly physical activity level as recommended by health authorities.