Diaphragm Function and Urinary Incontinence in Stroke
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- This is an observational study: the protocol does not assign a study treatment.
- Who it may be relevant to
- Registry conditions: Stroke. Basic parameters: 40 years — 75 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Center list to be confirmed — check the primary protocol.
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
Unsure about the terms? Read our patient guide →
Official title
Investigation of the Relationship Between Diaphragm Muscle Function and Urinary Incontinence in Stroke Patients
Overview
Stroke affects respiratory functions by causing structural and strength impairments in both inspiratory and expiratory respiratory muscles. Weakening of the diaphragm leads to a decrease in maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), which may result in respiratory insufficiency, postural instability, and urinary incontinence (UI). Additionally, post-stroke reduction in diaphragmatic mobility and decreased activity of the diaphragm and abdominal muscles on the paretic side may disrupt the piston mechanism between the diaphragm and pelvic floor muscles. These mechanical changes may trigger the development of urinary incontinence. This study aims to investigate the relationship between diaphragm muscle strength and endurance and urinary incontinence in 50 stroke patients. In addition, diaphragmatic function and posture-related respiratory changes will be evaluated using functional tests based on the Dynamic Neuromuscular Stabilization (DNS) approach. The relationship between respiratory muscle strength (MIP, MEP) and endurance and the scores of the Urogenital Distress Inventory (UDI-6) and the Incontinence Impact Questionnaire (IIQ-7) will be analyzed. Furthermore, individuals with and without urinary incontinence symptoms will be evaluated in terms of diaphragmatic function and contribution to respiration.
Primary outcome measures
- Diaphragm Muscle Function [Time frame: Baseline (single assessment)]
- Urogenital Distress Inventory (UDI-6) [Time frame: Baseline (single assessment)]
- Incontinence Impact Questionnaire (IIQ-7) [Time frame: Baseline (single assessment)]
Secondary outcome measures (2)
- Respiratory Muscle Strength [Time frame: Baseline (single assessment)]
- Respiratory Muscle Endurance [Time frame: Baseline (single assessment)]
Eligibility criteria
Inclusion criteria
- Aged between 40 and 75 years,
- Diagnosed with hemorrhagic or ischemic stroke confirmed by computed tomography (CT) or magnetic resonance imaging (MRI) conducted by a specialist physician,
- Presence of urinary incontinence,
- No other orthopedic, rheumatologic, or neurological diagnoses apart from stroke,
- Ability to understand the investigator's instructions and a score of ≥24 on the Mini-Mental State Examination (MMSE),
- Voluntary participation in the study,
- Ability to speak and understand Turkish.
Exclusion criteria
- Presence of serious diseases affecting vital organs such as the heart, lungs, liver, or kidneys,
- Presence of a genitourinary infection,
- Pelvic organ prolapse at stage 3 or higher,
- Uncontrolled cardiopulmonary or unstable chronic diseases,
- Presence of one or more neurological disorders that may cause balance impairments,
- Severe cognitive, speech, or visual impairments,
- History of urogynecological surgery within the past 6 months,
- History of abdominal surgery within the past 6 months.
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Observational model
- Case-only
Study locations
Center list to be confirmed — check the primary protocol.
Publications
- Zachovajeviene B, Siupsinskas L, Zachovajevas P, Venclovas Z, Milonas D. Effect of diaphragm and abdominal muscle training on pelvic floor strength and endurance: results of a prospective randomized trial. Sci Rep. 2019 Dec 16;9(1):19192. doi: 10.1038/s41598-019-55724-4. PMID 31844133
- Kobesova A, Davidek P, Morris CE, Andel R, Maxwell M, Oplatkova L, Safarova M, Kumagai K, Kolar P. Functional postural-stabilization tests according to Dynamic Neuromuscular Stabilization approach: Proposal of novel examination protocol. J Bodyw Mov Ther. 2020 Jul;24(3):84-95. doi: 10.1016/j.jbmt.2020.01.009. Epub 2020 Feb 8. PMID 32826013
- Tutuneken YE, Cakmak O, Demir B, Yildirim SY, Anlar E, Ozkul ME. Relationship between diaphragmatic muscle function and urinary incontinence in individuals with stroke: a prospective observational study. Top Stroke Rehabil. 2026 Feb 18:1-10. doi: 10.1080/10749357.2026.2634288. Online ahead of print. PMID 41704224
Identifiers
NCT: NCT07048210 · IstinyeUni-STROKE-2025