Wobbly shoes to stop those endless trips to the loo

WOBBLY shoes may reduce the symptoms of incontinence.

The special shoes, with balls on the soles, make walking unstable and require extra effort from muscles to balance — this is said to strengthen pelvic floor muscles.

U.S. researchers say the shoes could have the same effect as pelvic floor exercises, which have proven benefits for incontinence, and are testing the shoes in a study of more than 60 women.

Incontinence is thought to affect up to six million people in the UK, and is more common in women, as pregnancy, childbirth and menopause can weaken the muscles that control urination.

There are two main types: stress and urge incontinence. In stress incontinence, the pelvic floor muscles (the band of muscles that stretches under the pelvis and supports the bladder) are too weak to prevent urination, causing leaks when the bladder is under pressure — such as when coughing or laughing.

meanwhile, urge incontinence is where urine leaks as a result of a sudden, intense need to go to the loo. This is caused by overactivity of the detrusor muscles, which control the bladder.

THeRe is a range of treatments used for both conditions, such as cutting out caffeine (this irritates the bladder) and exercises and electrical stimulation to strengthen the pelvic muscles.

The problem is that patients often forget to do the exercises or find them difficult to master.

Surgery is also used in more severe cases, but this has risks and long-term complications.

The shoes, called aposTherapy, were originally developed as a treatment for arthritis. They have two large, semi-circular caps, like a cricket ball cut in half, on the heel and sole. patients walk on these round surfaces, and studies have suggested they are effective — in a study published recently in the Journal of orthopaedic Surgery and Research, arthritis patients who wore the shoes daily reported a 75 per cent reduction in pain, stiffness and movement problems after six months.

The idea in treating arthritis was that the shoes alter the way patients plant their feet on the floor, thereby taking the load away from worn-out or damaged areas of the joints and moving it to other, stronger joints.

The shoes also create instability underfoot, so leg muscles and tendons, which weaken with age and injury, are forced to readjust, strengthening them. Researchers leading the incontinence trials say these changes in movement will also strengthen pelvic floor muscles. ‘The [movements] cause changes in balance and gait that create dynamics similar to exercises which have shown benefit for incontinence,’ they said.

‘Instead of instructing patients to contract the lower trunk and pelvic floor muscles . . . the shoes help make this muscle contraction without the patient realising.’

In the trial at montefiore medical Center, new York, 64 women with stress incontinence will have six pelvic floor exercise sessions and training to complete at home. Half the group will also have five assessments using the shoes and will wear them while doing everyday activities at home. effects on incontinence will be compared after six months.

Commenting on the research, Raj persad, a consultant urologist at north Bristol nHS Trust, said: ‘This seems ingenious. The issue with pelvic floor exercises is that a patient has to remember to do them. a tool such as this, which coincidentally exercises the pelvic floor, takes off that pressure.’

meanWHIle, jabs of stem cells may also treat incontinence. doctors at ain Shams University in egypt are taking stem cells, which have the ability to transform into any cell, from the bone marrow of around 50 women and injecting them into muscles around their bladder.

The theory is that stem cells will strengthen the weakened or damaged sphincter muscle that’s responsible for urination.

patients will receive either three stem cell injections or traditional surgical treatment, and the results will be compared.