Effects of physiotherapy treatment for urinary incontinence in patient with multiple sclerosis.
Carla Maria de Abreu Pereira, Mariane Castiglione, Karina Tamy Kasawara
PMID 28744060WHAT IT FOUND
In one woman with multiple sclerosis and mixed urinary incontinence, leakage and quality-of-life scores improved after a combined programme of pelvic-floor electrical stimulation, active pelvic-floor exercises, tibial-nerve stimulation, home exercises and behavioral rehabilitation.
No comparison was done, so the package cannot be separated.
Key findings
01After 15 physiotherapy sessions, the patient's ICIQ-SF score fell from 19 to 3 and stayed 3 at five months.
02Pelvic-floor muscle strength on the modified Oxford scale rose from grade 1 to grade 2 and remained grade 2 after five months.
03The OAB-V8 score fell from 40 to 10 and stayed 10, and the voiding diary showed daytime frequency fell from 11 to 6 episodes with no nocturia or enuresis after treatment.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only one patient was treated, and there was no comparison group, so improvement cannot be separated from natural variation, placebo or other care. The patient received several treatments together, so the contribution of any single component cannot be separated. The pad test was inconclusive because the patient could not complete it, leaving objective urine-loss measurement incomplete. The patient had additional multiple sclerosis outbreaks after treatment began, and urinary symptoms did not worsen. It is hard to judge whether treatment changed her course. Follow-up was only five months.
The easy way to misread this
Do not conclude that any part of this physiotherapy programme works for multiple sclerosis-related urinary incontinence. It describes one patient who received several treatments together, had no comparison group, and an inconclusive pad test.