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Comparison of pelvic floor muscle training, electromyography biofeedback, and neuromuscular electrical stimulation for bladder dysfunction in people with multiple sclerosis: a randomized pilot study.
Neurourol Urodyn 2006; 25(4):337-48NU

Abstract

AIM

Bladder dysfunction affects up to 90% of the multiple sclerosis (MS) population. Interventions such as Pelvic Floor Training and Advice (PFTA), Electromyography (EMG) Biofeedback, and Neuromuscular Electrical Stimulation (NMES) have received limited research attention within this population. This study aimed to determine the effectiveness of a combined programme of PFTA, EMG Biofeedback, and NMES for bladder dysfunction in MS.

METHODS

Females (n = 30) who fulfilled strict inclusion/exclusion criteria were recruited. Outcome measures (weeks 0, 9, 16, and 24) included: 3-day Voiding Diary; 24 hr Pad-Test; Uroflowmetry; Pelvic Floor Muscle Assessment; Incontinence Impact Questionnaire (IIQ); Urogenital Distress Inventory (UDI); King's Health Questionnaire (KHQ), and the Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54). Following baseline (week 0) assessment, participants were randomly allocated, under double blind conditions, to one of the three groups: Group 1 (PFTA); Group 2 (PFTA and EMG Biofeedback); and Group 3 (PFTA, EMG Biofeedback, and NMES). Treatment was for 9 weeks.

RESULTS

Baseline severity (measured by number of leaks and pad weight) showed some variation between groups, although not statistically significant (P > 0.05); with the caveat that this baseline imbalance makes interpretation difficult, a picture emerges that at week 9, Group 3 demonstrated superior benefit as measured by the number of leaks and pad test than Group 2, with Group 1 showing less improvement when compared to week 0; this was statistically significant between Groups 1 and 3 for number of leaks (P = 0.014) and pad tests (P = 0.001), and Groups 1 and 2 for pad tests (P = 0.001). A similar pattern was evident for all other outcome measures.

CONCLUSION

Results suggest that these treatments, used in combination, may reduce urinary symptoms in MS. Further research will establish the effectiveness of these interventions.

Authors+Show Affiliations

Health and Rehabilitation Sciences Research Institute, University of Ulster, Newtownabbey, Northern Ireland.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

16637070

Citation

McClurg, D, et al. "Comparison of Pelvic Floor Muscle Training, Electromyography Biofeedback, and Neuromuscular Electrical Stimulation for Bladder Dysfunction in People With Multiple Sclerosis: a Randomized Pilot Study." Neurourology and Urodynamics, vol. 25, no. 4, 2006, pp. 337-48.
McClurg D, Ashe RG, Marshall K, et al. Comparison of pelvic floor muscle training, electromyography biofeedback, and neuromuscular electrical stimulation for bladder dysfunction in people with multiple sclerosis: a randomized pilot study. Neurourol Urodyn. 2006;25(4):337-48.
McClurg, D., Ashe, R. G., Marshall, K., & Lowe-Strong, A. S. (2006). Comparison of pelvic floor muscle training, electromyography biofeedback, and neuromuscular electrical stimulation for bladder dysfunction in people with multiple sclerosis: a randomized pilot study. Neurourology and Urodynamics, 25(4), pp. 337-48.
McClurg D, et al. Comparison of Pelvic Floor Muscle Training, Electromyography Biofeedback, and Neuromuscular Electrical Stimulation for Bladder Dysfunction in People With Multiple Sclerosis: a Randomized Pilot Study. Neurourol Urodyn. 2006;25(4):337-48. PubMed PMID: 16637070.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of pelvic floor muscle training, electromyography biofeedback, and neuromuscular electrical stimulation for bladder dysfunction in people with multiple sclerosis: a randomized pilot study. AU - McClurg,D, AU - Ashe,R G, AU - Marshall,K, AU - Lowe-Strong,A S, PY - 2006/4/26/pubmed PY - 2006/10/13/medline PY - 2006/4/26/entrez SP - 337 EP - 48 JF - Neurourology and urodynamics JO - Neurourol. Urodyn. VL - 25 IS - 4 N2 - AIM: Bladder dysfunction affects up to 90% of the multiple sclerosis (MS) population. Interventions such as Pelvic Floor Training and Advice (PFTA), Electromyography (EMG) Biofeedback, and Neuromuscular Electrical Stimulation (NMES) have received limited research attention within this population. This study aimed to determine the effectiveness of a combined programme of PFTA, EMG Biofeedback, and NMES for bladder dysfunction in MS. METHODS: Females (n = 30) who fulfilled strict inclusion/exclusion criteria were recruited. Outcome measures (weeks 0, 9, 16, and 24) included: 3-day Voiding Diary; 24 hr Pad-Test; Uroflowmetry; Pelvic Floor Muscle Assessment; Incontinence Impact Questionnaire (IIQ); Urogenital Distress Inventory (UDI); King's Health Questionnaire (KHQ), and the Multiple Sclerosis Quality of Life-54 Instrument (MSQoL-54). Following baseline (week 0) assessment, participants were randomly allocated, under double blind conditions, to one of the three groups: Group 1 (PFTA); Group 2 (PFTA and EMG Biofeedback); and Group 3 (PFTA, EMG Biofeedback, and NMES). Treatment was for 9 weeks. RESULTS: Baseline severity (measured by number of leaks and pad weight) showed some variation between groups, although not statistically significant (P > 0.05); with the caveat that this baseline imbalance makes interpretation difficult, a picture emerges that at week 9, Group 3 demonstrated superior benefit as measured by the number of leaks and pad test than Group 2, with Group 1 showing less improvement when compared to week 0; this was statistically significant between Groups 1 and 3 for number of leaks (P = 0.014) and pad tests (P = 0.001), and Groups 1 and 2 for pad tests (P = 0.001). A similar pattern was evident for all other outcome measures. CONCLUSION: Results suggest that these treatments, used in combination, may reduce urinary symptoms in MS. Further research will establish the effectiveness of these interventions. SN - 0733-2467 UR - https://www.unboundmedicine.com/medline/citation/16637070/Comparison_of_pelvic_floor_muscle_training_electromyography_biofeedback_and_neuromuscular_electrical_stimulation_for_bladder_dysfunction_in_people_with_multiple_sclerosis:_a_randomized_pilot_study_ L2 - https://doi.org/10.1002/nau.20209 DB - PRIME DP - Unbound Medicine ER -