Benefits of Pelvic Floor Muscle Training in Multiple Sclerosis Patients with LUTD

25 May, 22

Introduction

The incidence of lower urinary tract dysfunction (LUTD) is quite significant in patients with multiple sclerosis (MS). Pelvic floor muscle training (PFMT) is recommended as first-line conservative treatment for the management of LUTD in people with MS. Although there are studies on efficacy of PFMT in LUTD people with MS, there is no meta-analysis that assesses the benefits of PFMT in this population.

Aim

This systematic review and meta-analysis evaluated the overall efficacy of PFMT on LUTD in people with MS.

Method

Study Design

Systematic review and meta-analysis.

Treatment Strategy

Extensive search of PubMed/Medline, Scopus, PEDro, WOS, CINAHL, Cochrane, and Embase databases was performed to identify the eligible studies.
The neurogenic bladder symptoms were assessed by the overactive bladder questionnaire (OAB-V8 questionnaire) which rated the 4 OAB symptoms: urinary frequency, urgency, nocturia and urge incontinence.
The power and endurance of pelvic floor muscles was also evaluated.

Endpoints

Primary Endpoint

Urinary leakage

Secondary Endpoints

Neurogenic bladder symptoms
Pelvic floor muscle function

Results

This meta-analysis included 15 studies.
PFMT significantly reduced the urinary leakage episodes [standardized mean difference (SMD) = 0.50].
The neurogenic bladder symptoms were also significantly decreased by PFMT in people with MS; SMD = -2.24.
The overall endurance and power of pelvic floor muscles significantly increased with PFMT; SMD = 1.25 and 0.64, respectively.

Conclusion

Pelvic floor muscle training resulted in significant reduction of urine leakage and neurogenic bladder symptoms, while increasing endurance and power of pelvic floor muscles in multiple sclerosis (MS) patients with lower urinary tract dysfunction (LUTD) as demonstrated by moderate and high-quality studies.

Mult Scler Relat Disord. 2022 Mar; 59:103559. Doi: 10.1016/j.msard.2022.103559.