Study shows the efficacy of Yoga of Immortals mobile app for urinary incontinence

People with loss of urinary control who used the Yoga of Immortals mobile app – a globally used app that combines specific yogic postures in the Sanatan tradition with breathing exercises, sound therapy and meditation – found significant improvement in the frequency and severity of urine leaks at four weeks of practice, according to a Rutgers study.

Urinary incontinence is more common in women compared to men. An estimated 25 to 45 percent of women globally suffer from the condition, which can adversely affect quality of life and create difficulties in social, psychological and sexual functioning. However, only less than 20 percent of affected people seek treatment, which includes medications, pelvic floor muscle physical therapy to strengthen pelvic floor muscles or surgical procedures.

Although these treatments are effective, there are many shortcomings: Medications have poor compliance and potential significant side effects; patients often lack the knowledge to identify specific pelvic muscles and motivation to complete physical therapy and the surgical procedures are invasive with potential complications."

Hari Tunuguntla, lead author of the study and Associate Professor of Urological Surgery at Rutgers, Robert Wood Johnson Medical School

"However, the 30-minute daily app sessions are easy, safe, effective and convenient as they can be done anytime and anywhere without the need for in-person visits to the health-care provider," he continued. "The app-based YOI practice involves specific breathing exercises, stimulation of the body's specific energy centers for urinary control, postures to engage the pelvic floor, promote relaxation and muscle control, and alignment techniques to strengthen the pelvic floor."

The researchers selected Yoga of Immortals for study as it provides precise video and audio instruction for this comprehensive program that engages the pelvic floor and specific energy centers of the urinary system. The YOI protocols have been shown in the study to be easily understood by participants at all education levels. YOI practice also includes breath work to enhance detoxification, mindfulness and meditation. YOI has also been shown to address mental health and quality-of-life issues resulting from depression, stress and anxiety.

The study, published in the journal Urology (the Gold Journal), is the first to the researchers' knowledge to determine the efficacy of a mobile app-based Yoga of Immortals intervention for urinary incontinence on a global scale among various ages and ethnic groups in both men and women. (Tunuguntla also recently published a study in the journal International Journal of Environmental Research and Public Health that found people who used Yoga of Immortals reported it reduced their anxiety, depression and insomnia.)

In this study, the researchers sent a survey to app subscribers to identify those who were experiencing a loss of bladder control of different types – urine leak from not being able to reach the restroom in time or loss of urine after sneezing, coughing or laughing; or a combination – and of all types of severity of urine leak. The 258 subscribers from 23 countries between the ages of 18 and 74 – the majority being women and between 18 and 44 – were sent questionnaires at four weeks and eight weeks to report on condition improvement. The researchers then assessed their responses using specific questionnaires and the Patient Global Impression of Improvement scale, which measures the subjective efficacy of therapy.

The researchers found 76 percent of the respondents felt much better at four weeks with significant improvement in frequency and severity of urine leak without in-person visits to the healthcare provider – many of whom reported continuing improvement at eight weeks. Those with more severe leakage reported the most improvement in daily life activity and quality of life. Most of the study participants felt "much better" at the conclusion of the study.

The app can potentially increase adherence to treatment and may be used to complement other treatments, the researchers said.

"Due to its convenience, flexibility and efficacy, the app may increase access to care and serve as first-line treatment for both women and men with urinary incontinence. This is an easily accessible, self-management treatment," Tunuguntla said. "However, further studies are needed to test the app's efficacy in improving this condition long term."