Efficacy of pelvic floor exercise in the treatment of lower urinary tract symptoms in women with multiple sclerosis / Eficacia dos exercicios do assoalho pelvico no tratamento dos sintomas do trato urinario inferior em mulheres portadoras de esclerose multipla

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Aims: The aim of the present study is to evaluate the role of Pelvic Floor Muscle Training (PFMT) in the treatment of Lower Urinary Tract Symptoms (LUTS) in women with MS and its consequence on Quality of Life (QoL). Methods: A prospective, randomized and blind clinical trial was developed. Twenty seven female patients with a diagnosis of MS and LUTS complaints were divided in two groups: treatment group (N=13) and placebo group (N=14). Evaluation included: level of neurologic disabilities by the Expanded Disability Status Scale EDSS, evaluation of LUTS through the Overactive Bladder Questionnaire - OAB-V8, the questionnaires of Quality of Life SF-36, ICIQ-SF and Qualiveen. 24-hour Pad testing, three day voiding diary, pelvic floor evaluation according to PERFECT scheme and Urodynamic study. Intervention was performed twice a week by the same physiotherapist for a period of 12 weeks in both groups. The treatment group performed PFMT with assistance of a vaginal perineometer and instructions to practice the exercises daily at home. In the placebo group a perineometer was introduced in the vagina and no contractions were required. Pre and post intervention data were recorded. Results: At the end of the treatment, the treatment group presented significant differences regarding to time in OAB-V8 scores (p <0.0001), bodily pain domain of SF-36 (p = 0.0013), ICIQ-SF (p <0.0001) and in GQoL (p = 0.0185) and SIUP (p = 0.0013) domains of Qualiveen questionnaire. There was a reduction of pad weight (p <0.0001), number of Used pads (p= 0.0011), nocturia (p <0.0001) and daytime frequency (p = 0.0348). In the PERFECT scheme there was improvement on muscle Power (p = 0.0011), endurance (p <0.0001), resistance (p <0.0001) and fast contractions (p = 0.0004). In the same way, it was observed a increasing of Maximum Flow Rate (p = 0.0024) and decreasing of Post Void Residual (p = 0.0014). According to group, the treatment group showed significant differences in OAB-V8 (p <0.0001), ICIQ-SF (p = 0.0003), in GQoL (p = 0.0443) and SIUP (p = 0.0001) domains of Qualiveen. There was a reduction on pad weight (p = 0.0011), number of pads (p = 0.0159) and nocturia events (p <0.0001) and improvement of muscle power (p = 0.0026) endurance (p <0.0001), resistance (p <0.0001) and fast contraction (p <0.0001). No differences were found in placebo group. Conclusion: PFMT is an effective approach to treat LUTS in women with MS and diminish the impact of QoL in these patients

ASSUNTO(S)

quality of life urinary tract multiple sclerosis qualidade de vida assoalho pelvico pelvic floor esclerose multipla trato urinario

ACESSO AO ARTIGO

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