Introduction: Age-related co-morbidities are common among persons living with chronic Human Immunodeficiency Virus (HIV). However, data are largely absent on the relationship between frailty and incontinence as related to falls—common age-related co-morbidities—among people living with chronic HIV (PLWH). Methods: To inform hospital-based Occupational Therapy (OT) services for PLWH, we performed a case-control study using extracted data from the electronic medical records of PLWH who had received OT at a large academic hospital. Two-hundred-and-four subjects were included in the final dataset; sixty-eight were cases that reported a fall within the last 12 months, while 136 were controls which were PLWH who had not sustained a fall. Results: The association between falls and frailty indicated that persons categorized as ‘pre-frail’ with balance deficits were more likely to fall (OR=2.77 [1.18-6.52]). Women who lacked insurance were less likely to fall (OR=0.38 [0.18-0.82]) and (OR=0.29 [0.09-0.88]) respectively. The association between incontinence and falls among PLWH were not statistically significant in a multivariate adjusted regression model (OR=1.38 [.59-3.22]). Conclusion: Our findings suggest further examination of the person factors of PLWH who are categorized clinically as ‘pre-frail’ or ‘frail’ may improve health outcomes and reduce falls when paired with occupation-based interventions.

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the “avoidance” subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the “desire” score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

골반저근은 골반기관을 지지하는 기능을 가지고 있으며 요자제를 유지하는 여성의 주요 하부조직이다. 골반저근의 약화는 복압성 요실금의 원인이 되는데, 이러한 골반저근의 기능 정도는 복압성 요실금의 병증정도를 평가하는 지표로 사용될 수 있다. 이에 본 연구에서는 골반저근의 수축 압력을 측정하여 복압성 요실금의 병적 진행정도를 정량적으로 진단할 수 있는 요실금 진단 알고리즘을 제안하였다. 이를 위하여 골반저근의 수축압력 정보를 측정할 수 있는 시스템을 제작하였으며, 측정된 데이터의 특징 분석을 위한 측정 프로토콜을 제안하였다. 복압성 요실금 환자로부터 획득한 데이터를 이용하여 5개의 진단 파라미터를 추출하였으며, 이를 이용한 진단 알고리즘을 구현하였다. 임상시험을 통하여 진단 알고리즘의 정확성을 평가한 결과 80%의 정확성을 보였으며, 20%의 위양성 진단 결과를 보였다. 반면에 위음성 진단 결과는 확인되지 않았다. 본 연구에서 제안한 요실금 진단 알고리즘은 복압성 요실금의 병적 진행 정도를 정량적으로 진단할 수 있으며, 요실금 진단 시스템 개발에 활용될 수 있을 것으로 판단된다.