Statistical analysis
Participants characteristics are shown as percentages or as means and
standard deviations. The associations of previous and current physical
activity with symptoms of pelvic floor disorders were analyzed using
logistic regression models. The confounding factors included in the
models were age, BMI, education, physical workload, menopausal status,
parity, and hysterectomy status, since it is known that demographical
factors as well as factors related to gynaecological history may affect
pelvic floor disorders and physical activity. The model assumptions were
tested using correlation analysis and inspecting residual plots as well
as scatter plots between each continuous predictor and the logit values.
Statistical analyses were performed using R and IBM SPSS Statistics 22.0
(SPSS Inc., Chicago, IL). The level of significance was set at p≤0.05.
RESULTS
Differences in the reported frequencies of pelvic floor disorders
between larger Phase 1 study sample and the smaller Phase 3 sample were
minor, indicating good representativeness of the analytical sample
(Table 1). About 55% of women reported to have any type of disorder and
about 19% experienced more than one pelvic floor disorder type. Most
common disorder types were stress urinary incontinence (40%),
constipation or defecation difficulties (17%) and urge urinary
incontinence (14%). Feeling of pelvic organ prolapse (5%) and fecal
incontinence (3%) were less often reported.
Table 2 shows demographical, gynaecological, and physical activity
status in total analytical sample and in participants with different
types of pelvic floor disorders. The mean age of the participants was
51.2 (SD = 2.0) years. On average, the participants were slightly
overweight according to the mean BMI of 25.5 (SD = 3.7). Most (59%) of
them had education lower than bachelor level and half (53%) reported
their work-related physical activity as light. i.e. mainly sedentary
work. Based on serum concentrations of the circulating hormones and
bleeding diaries 28% of the women were categorized as premenopausal,
18% early perimenopausal, 19% late perimenopausal, and 35%
postmenopausal. The means for number of gestations and parity were 2.5
and 2.0, respectively. About 8% of women had undergone hysterectomy.
Groups of women reporting different types of pelvic floor symptoms were
fairly similar except that women with feeling of pelvic organ prolapse
were less likely to report mainly sedentary work (36%), were more
likely to be postmenopausal (41%), had a little bit higher number of
gestations (3.2 [SD = 1.8]) and were more likely to have had
hysterectomy (20%) than women in other groups. Furthermore, in
comparicon to other groups, group of women with fecal incontinence had
highest BMI (27.1) and lowest education level (74% reported secondary
education).
The mean for current physical activity was 4.5 MET-h/d (SD = 3.9) for
total analytical sample and ranged from 3.6 to 4.4 MET-h/d for women
reporting different types of pelvic floor symptoms. With regard to
previous physical activity, 24% of the women were inactive, 67% took
part in regular physical activity, and 10% did competitive sports
during their early adulthood. Most (90%) of the women reporting fecal
incontinence had exercised regularly, but only one of them (3%)
recalled that she had practiced competitive sports. Women reporting urge
urinary incontinence formed the group with highest number of competitive
sport athletes during early adolescent (13%).
Simple logistic regression models indicated higher current physical
activity to associate only with lower odds of experiencing stress
urinary incontinence (OR 0.96, CI 0.93–0.99, p=0.023, Table S1) but not
with any other pelvic floor disorder types. However, including early
adulthood physical activity, and demographical and gynaecological
variables as potential confounding factors into the same model abolished
statistical significance of the association (Table 3).
In comparison to not exercising during early adulthood, women with
history of competitive sports were more likely to experience urge
urinary incontinence according to simple (OR 2.07, CI 1.07–4.00,
p=0.031, Table S1) and multiple logistic regression models (OR 2.16, CI
1.10–4.24, p=0.025, Table 3) controlled for current physical activity
and several demographical and gynaecological factors. Early adulthood
competitive sport participation did not associate with other pelvic
floor dysfunction types. Similarly, women with history of regular
physical activity were more likely to experience fecal incontinence (OR
4.41, CI 1.05–18.49 p=0.043, Table 3) but no significant associations
were found for other pelvic floor disorders