骨盆底瑜珈常被建議作為女性尿失禁(UI)的輔助治療策略，但其療效證據仍不足。此研究在美國加州三個研究中心進行，評估一個骨盆底瑜珈課程，與一般體能訓練課程相比，對女性尿失禁的效果。240 位 45~90 歲的女性，每天都有漏尿(急迫性、壓力性或混合型)。分成兩組：瑜珈組：做專門訓練骨盆底的哈達瑜珈。運動組：做一般伸展和肌力訓練。每週上課 2 次 + 自己練習 1 次，持續 12 週。研究結果為兩組都有改善，每天漏尿的次數明顯下降。但是骨盆瑜珈並沒有特別優於一般運動。換句話說：規律運動(不管是瑜珈還是伸展肌力運動)對漏尿都有幫助。本篇研究給我們的訊息有幾個：1. 想改善漏尿，不一定要特別去學瑜珈。2. 只要選擇自己喜歡、能持續做的運動，就能幫助改善尿失禁。3. 骨盆底運動(凱格爾運動)仍是基礎，但搭配一般運動也有好處。

Background: Pelvic floor yoga has been recommended as a complementary treatment strategy for urinary incontinence (UI) in women, but evidence of its efficacy is lacking.

Objective: To evaluate the effects of a therapeutic pelvic floor yoga program versus a nonspecific physical conditioning program on UI in women.

Design: Randomized trial. (ClinicalTrials.gov: NCT03672461).

Setting: Three study sites in California, United States.

Participants: Ambulatory women aged 45 years or older reporting daily urgency-, stress-, or mixed-type UI.

Intervention: Twelve-week program of twice-weekly group instruction and once-weekly self-directed practice of pelvic floor-specific Hatha yoga techniques (pelvic yoga) versus equivalent-time instruction and practice of general skeletal muscle stretching and strengthening exercises (physical conditioning).

Measurements: Total and type-specific UI frequency assessed by 3-day voiding diaries.

Results: Among the 240 randomly assigned women (age range, 45 to 90 years), mean baseline UI frequency was 3.4 episodes per day (SD, 2.2), including 1.9 urgency-type episodes per day (SD, 1.9) and 1.4 stress-type episodes per day (SD, 1.7). Over a 12-week time period, total UI frequency (primary outcome) decreased by an average of 2.3 episodes per day with pelvic yoga and 1.9 episodes per day with physical conditioning (between-group difference of -0.3 episodes per day [95% CI, -0.7 to 0.0]). Urgency-type UI frequency decreased by 1.2 episodes per day in the pelvic yoga group and 1.0 episode per day in the physical conditioning group (between-group difference of -0.3 episodes per day [CI, -0.5 to 0.0]). Reductions in stress-type UI frequency did not differ between groups (-0.1 episodes per day [CI, -0.3 to 0.3]).

Limitation: No comparison to no treatment or other clinical UI treatments; conversion to videoconference-based intervention instruction during the COVID-19 pandemic.

Conclusion: A 12-week pelvic yoga program was not superior to a general muscle stretching and strengthening program in reducing clinically important UI in midlife and older women with daily UI.