Anorectal dysfunction in multiple sclerosis patients: A pilot study on the effect of an individualized rehabilitation approach.
Martina Kovari, Jan Stovicek, Jakub Novak and 5 others
PMID 34776431WHAT IT FOUND
Ten women with MS who completed a 10-week physiotherapy program plus self-treatment reported significantly less fecal incontinence on a subjective score.
Objective anal pressure measurements showed no significant change, so the benefit was felt by patients but not confirmed by physical testing.
Key findings
01Subjective incontinence scores improved significantly from baseline after supervised therapy and remained lower after self-treatment.
02Objective anorectal manometry measures showed no statistically significant differences over time.
03The rehabilitation program combined manual therapy, electrical stimulation or biofeedback, postural training, and individualized self-treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no control group, so it is impossible to know if the improvements were due to the treatment or natural variation. Only 10 of the initial 20 patients completed the study, meaning half dropped out due to relapse, discomfort, or inability to comply with the regimen. The sample was small and consisted only of women, limiting generalizability to men or broader MS populations. The intervention was complex and individually tailored, making it difficult to identify which specific component caused the subjective improvement.
Declared interests
The study was supported by the institutional research program Progress Q41 and the foundation Movement without Help. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that objective pelvic floor strength has improved. While patients reported feeling better, the physical measurements of anal pressure did not change significantly, so the treatment's effect on actual muscle function remains unproven.