Lessening Incontinence Through Low-impact Activity

Inclusion Criteria:

- Women aged 50 years or older who report urinary incontinence starting at least 3
months prior to screening

- Self-report at least required frequency of urinary incontinence episodes on a
screening 3-day voiding diary

- Self-report urgency-predominant (i.e., at least half of incontinence episodes being
urgency-type), stress-predominant (i.e., at least half of episodes being stress-type),
or mixed-type (i.e., an equal number of stress- and urgency-type episodes)
incontinence on the screening voiding diary

- Willing to refrain from initiating medical treatments that may affect their
incontinence or voiding pattern during the study intervention period

Exclusion Criteria:

- Participation in formal or organized yoga classes or instruction within the past 3
months; or any prior yoga therapy directed specifically at improving urinary
incontinence or pelvic floor dysfunction

- Participation in at least weekly organized physical conditioning classes or
instruction in the past 3 months involving muscle stretching and strengthening
exercises (not including aerobic classes that do not emphasize stretching or
strengthening).

- Currently pregnant (by self-report or screening urine pregnancy test), gave birth
within the past 6 months, or planning pregnancy during the study period (approximately
2 to 6 months)

- Current urinary tract infection (screening dipstick urinalysis with leukocyte estrace,
nitrites or blood) or a history or 3 or more urinary tract infections in the preceding
year

- Report history of neurologic conditions such as stroke, multiple sclerosis, spinal
cord injury, or Parkinson's disease, or a lumbosacral spine condition associated with
neurological symptoms

- Unable to walk up a flight of stairs or at least 2 blocks on level ground without
assistance (i.e., functional capacity < 4 METs)

- Unable to get up from a supine to a standing position in 10 seconds or less and
without assistance

- Morbid obesity defined by a measured body mass index of >40 kg/m2 at the screening
evaluation.

- Report any history of prior anti-incontinence or urethral surgery (not including
urethral dilation), pelvic cancer, or pelvic irradiation for any reason

- Report use of bladder botox, electrostimulation, bladder training, or pelvic floor
exercise training (with certified practitioners) in the past 3 months

- Report other surgery to the pelvis (hysterectomy, oophorectomy, vaginal surgery,
bladder surgery, colon surgery) within the past 3 months

- Report use of medications with the potential to affect incontinence (anticholinergic
bladder medications, tricyclic antidepressants, selective norepinephrine reuptake
inhibitors, mirabegron, loop diuretics) within the past month

- Report starting stopping, or changing the dose of a medication with the potential to
affect anxiety or stress symptoms (i.e., selective serotonin reuptake inhibitors,
anxiolytics/sedatives, antipsychotics) within the past 1 month, or plans to start,
stop, or change to dose of such a medication during the study period

- Report use of medical devices (i.e. pessary) for incontinence within the previous
month (participants may stop use of device and re-present for study)

- Report history of interstitial cystitis, fistula or hole in bladder or rectum, or
birth defect leading to urine leakage

- Report symptomatic pelvic organ prolapse (assessed using a standardized question,
""Have your pelvic organs (uterus, bladder, or rectum) been dropping out of your
vagina causing a feeling of bulging, pressure, or protrusion or a sensation like your
"insides are coming out"?")

- Report history of vulvodynia, chronic pelvic pain, or pain when practicing pelvic
floor exercises

- Report conditions that, in the judgment of the investigators, render potential
participants unlikely to follow the protocol, including plans to move, substance
abuse, significant psychiatric problems, or dementia

- Participation in another research study that involves investigational drugs or devices
that could potentially confound the results of this study

- Unable to understand study procedures, complete study interviews, or and provide
informed consent in English