title: Pelvic floor muscle training in spinal cord injury and its impact on neurogenic detrusor over-activity and incontinence.
abstract: METHODS
  Two case studies.
  
  
  OBJECTIVE
  To determine whether 6 weeks of regular pelvic floor muscle training (PFMT) can improve the strength and endurance of voluntary contractions in incomplete spinal cord injury and reduce neurogenic detrusor over-activity (NDO) and incontinence.
  
  
  METHODS
  The London Spinal Cord Injury Centre, Stanmore, London, UK.
  
  
  METHODS
  A 6-week programme of PFMT was conducted in two male subjects with stable supra-sacral motor incomplete (AIS C and D) spinal cord injuries. Clinical evaluations before and after training comprised measures of strength and endurance of voluntary pelvic floor contractions both objectively by anal canal-pressure measurements and subjectively using the modified Oxford grading system. NDO was determined by standard urodynamic tests of bladder function and incontinence measured by the International Consultation on Incontinence Questionnaire-Urology.
  
  
  RESULTS
  Both subjects improved the strength and endurance of their pelvic floor muscle contractions by over 100% at the end of training. After training, Subject 1 (AIS D) was able to reduce bladder pressure during over-activity almost completely by voluntarily contracting the pelvic floor muscles. Subject 2 (AIS C) achieved a lesser reduction overall after training. Continence improved only in subject 1.
  
  
  CONCLUSIONS
  These case studies provide evidence that a 6-week programme of PFMT may have a beneficial effect on promoting voluntary control of NDO and reduce incontinence in selected cases with a motor incomplete spinal cord lesion.
authors.affiliation: London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, London, UK.
authors.forename: N
authors.initials: N
authors.lastname: Vásquez
authors.affiliation: London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, London, UK.|Division of Surgery and Interventional Science, University College London, London, UK.
authors.forename: S L
authors.initials: SL
authors.lastname: Knight
authors.affiliation: London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Susser
authors.affiliation: London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Gall
authors.affiliation: London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, London, UK.|Department of Medicine, Division of Brain Sciences, Imperial College London, London, UK.
authors.forename: P H
authors.initials: PH
authors.lastname: Ellaway
authors.affiliation: London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, London, UK.|Division of Surgery and Interventional Science, University College London, London, UK.
authors.forename: M D
authors.initials: MD
authors.lastname: Craggs
mesh_terms: D019540:Area Under Curve; D005081:Exercise Therapy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D017773:Pelvic Floor / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000150:complications*; D053201:Urinary Bladder, Overactive / Q000209:etiology*; D014549:Urinary Incontinence / Q000209:etiology* / Q000534:rehabilitation