Pelvic floor muscle training in the treatment of lower urinary tract dysfunction in women with multiple sclerosis.
OBJECTIVE
Evaluate the role of pelvic floor muscle training (PFMT) on the treatment of lower urinary tract dysfunction (LUTD) in multiple sclerosis (MS) patients.


METHODS
In this randomized controlled trial, twenty seven female patients with a diagnosis of MS and LUTD complaints were randomized, in two groups: Treatment group (GI) (N = 13) and Sham group (GII) (N = 14). Evaluation included urodynamic study, 24-hr Pad testing, three day voiding diary and pelvic floor evaluation according to PERFECT scheme. Intervention was performed twice a week for 12 weeks in both groups. GI intervention consisted of PFMT with assistance of a vaginal perineometer. GII received a sham treatment consisted on the introduction of a perineometer inside the vagina with no contraction required.


RESULTS
At the end of the treatment GI was complaining less about storage and voiding symptoms than GII. Furthermore, differences found between groups were: reduction of pad weight (P = 0.00) (Mean: 87,51 grams initial and 6,03 grams final in GI. 69,46 grams initial and 75,88 grams final in GII), number of pads (P = 0.01) (Mean: 3,61 initial and 2,15 final in GI. 3,42 initial and 3,28 final in GII) and nocturia events (P < 0.00) (Mean: 2,38 initial and 0,46 final in GI. 2,55 initial and 2,47 final in GII) and improvements of muscle power (P = 0.00), endurance (P < 0.00), resistance (P < 0.00) and fast contractions (P < 0.00), domains of PERFECT scheme.


CONCLUSIONS
PFMT is an effective approach to treat LUTD in female with MS.
Lúcio
Adélia Correia
AC
University of Campinas-UNICAMP, Campinas, SP, Brazil. adeliac@fcm.unicamp.br
Campos
Renata Martins
RM
Perissinotto
Maria Carolina
MC
Miyaoka
Ricardo
R
Damasceno
Benito Pereira
BP
D'ancona
Carlos Arturo Levi
CA
D000328:Adult; D001938:Brazil; D005260:Female; D006801:Humans; D016496:Incontinence Pads; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology; D009119:Muscle Contraction; D053580:Muscle Strength; D053158:Nocturia / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D017773:Pelvic Floor / Q000503:physiopathology*; D026741:Physical Therapy Modalities; D013997:Time Factors; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology*; D014555:Urination Disorders / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics; D055815:Young Adult