AIM: To assess the effectiveness of conservative therapeutic approaches in a multiple sclerosis population.
MATERIAL: Review was performed in PubMed, PEDro, Scopus and Cochrane Library using combinations of the following keywords: multiple sclerosis; bladder dysfunction; overactive bladder; detrusor hyperreflexia; urge incontinence; urgency; stress incontinence; pelvic floor muscle; biofeedback; PTNS; tibial nerve; bladder training; physical therapy; physiotherapy; conservative treatment and behavioral therapy.
RESULTS: Six randomized articles including 289 patients were selected. Four papers exhibited strong scores for the methodological quality assessment. The parameters always significantly improved concerned: number of incontinence episodes (decreased from 64% to 86% after treatment versus before treatment), quality of life (P≤ 0.001), severity of irritative symptoms (decreased by more than 50% after treatment versus before treatment), and nocturia (P=0.035 to P< 0.001). Activities and participation, maximum flow rate, mean voided volume and daytime frequency were not significantly improved in all trials.
CONCLUSIONS: The physical therapy techniques could be effective for the treatment of urinary disorders in multiple sclerosis populations with mild disability. However, the analyses are based on six studies within only four showed good methodological quality. No strong conclusions regarding treatment approaches can be drawn from this review.
Written by:
Gaspard L, Tombal B, Castille Y, Opsomer RJ, Detrembleur C. Are you the author?
1Institute of NeuroScience, université Catholique de Louvain, Bruxelles, Belgique; Service de médecine physique et réadaptation, cliniques universitaires St-Luc, université Catholique de Louvain, 10, avenue Hippocrate, 1200 Bruxelles, Belgique; Service d'urologie, université Catholique de Louvain, cliniques universitaires Saint-Luc, Bruxelles, Belgique.
Reference: Prog Urol. 2014 Mar;24(4):222-8.
doi: 10.1016/j.purol.2013.11.004
PubMed Abstract
PMID: 24560290
Article in French.
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