Urinary incontinence in multiple sclerosis: prevalence, severity and impact on patients’ quality of life

Background: Multiple sclerosis (MS) presents with many debilitating symptoms, including urinary incontinence (UI), that physical therapy (PT) may address; UI is widely prevalent, but PT management of symptoms lacks consensus. A meta-analysis of long-term nonsurgical and nonpharmaceutical treatment options may supply this deficiency. We analyzed the current evidence for effectiveness of PT to decrease UI and improve quality of life (QOL) in people with MS. Methods: An electronic search conducted through November 26, 2013, included the following search terms: incontinence, bladder dysfunction, urinary incontinence, multiple sclerosis, MS, physical therapy, physiotherapy, therapy, and rehabilitation. Criteria for inclusion were as follows: MS diagnosis, intervention involved PT for UI or bladder dysfunction, outcomes assessed QOL or UI, and at least a 4 of 10 on the Physiotherapy Evidence Database scale or a 2b level of evidence. Outcomes were combined across studies, and effect sizes are depicted in forest plots. Results: Six studies met the inclusion criteria. Between-group analysis revealed statistically significant differences in incontinence episodes and QOL, but did not reach significance for functional control mechanisms (eg, electromyography data on strength of contraction, relaxation, and endurance). Incontinence leakage episodes and QOL participation improved within groups. Conclusions: Meta-analysis indicates support for PT for minimizing incontinence compared with pretreatment and affecting incontinence and QOL more than control in people with MS. Protocols were heterogeneous regarding duration and type of PT intervention and were applied in different types of MS. Further research may reveal the most effective combination and variety of PT interventions for people with MS.

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Effects of Pelvic Floor Muscle Exercises on Urinary Incontinence and Quality of Life in Patients with Multiple Sclerosis

World Family Medicine Journal/Middle East Journal of Family Medicine ◽

10.5742/mewfm.2018.93199 ◽

2018 ◽

Vol 16 (1) ◽

pp. 62-69 ◽

Cited By ~ 1

Author(s):

Forough Rafii ◽

Moosa Sajjadi ◽

Habib Shareinia

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Pelvic Floor Muscle Exercises

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Do Physical Therapy Interventions Improve Urinary Incontinence and Quality of Life in patient with Multiple Sclerosis: A systematic Literature Review

International Journal of Women’s Health Care ◽

10.33140/ijwhc.04.02.04 ◽

2019 ◽

Vol 4 (2) ◽

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Urinary Incontinence ◽

Physical Therapy ◽

Randomized Control Trials ◽

Randomized Control ◽

Therapy Interventions ◽

Therapy Intervention ◽

Physical Therapy Intervention

Background: Multiple sclerosis (MS) presents with many symptoms, including urinary incontinence (UI) that physical therapy can play very important role, which is widely prevent, but the physical therapy management for UI in MS population lacks consensus. We analyzed the current evidence for effectiveness of physical therapy to decrease UI and improve quality of life (QOL) in population with MS. Purpose: To systematically review the literature and present the best available evidence for the efficacy and effectiveness of physical therapy intervention in treating the urinary incontinence for MS population and improve QOL. Data Source: Pub Med, Cochrane library, BMJ Group, BioMed Central, Wiley online library, Cumulative Index to Nursing and Allied Health Literature, and PEDro. Study Selection: 5 randomized, control trials (RCTs) and one clinical trial published in English from 2006- May 2019. Data Extraction: Any study concentrated on surgical or pharmaceutical treatment interventions, focused on bowel incontinence or were not within the physical therapy scope of practice. Data Synthesis: The study focuses on physical therapy intervention for MS patients with UI and randomized control study. Limitation of the Study: The reviewed study is limited to 6 randomized control trials. Conclusion: There is significant evidence that physical therapy interventions in MS patients with urinary incontinence are very effective and had significant change in reducing UI and increasing QOL.

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Do Physical Therapy Interventions Improve Urinary Incontinence and Quality of Life in patient with Multiple Sclerosis: A systematic Literature Review

Physical Medicine and Rehabilitation Research ◽

10.15761/pmrr.1000204 ◽

2019 ◽

Vol 4 (3) ◽

Author(s):

Najwa Alfarra ◽

Hala Aldosary ◽

Sultan Almefleh

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Urinary Incontinence ◽

Physical Therapy ◽

Literature Review ◽

Systematic Literature Review ◽

Therapy Interventions

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573 ASSESS THE IMPACT OF URINARY INCONTINENCE ON QUALITY OF LIFE OF PATIENTS WITH MULTIPLE SCLEROSIS - MISSION IMPOSSIBLE?

European Urology Supplements ◽

10.1016/s1569-9056(11)60563-0 ◽

2011 ◽

Vol 10 (2) ◽

pp. 189

Author(s):

A. Ciudin ◽

L. Peri Cusi ◽

De Castro A. Franco ◽

A. Alcaraz Asensio

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Urinary Incontinence ◽

The Impact

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Comorbidity and Health-Related Quality of Life in People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073-11.1.6 ◽

2009 ◽

Vol 11 (1) ◽

pp. 6-16 ◽

Cited By ~ 26

Author(s):

Sharon A. Warren ◽

Karen V.L. Turpin ◽

Sheri L. Pohar ◽

C. Allyson Jones ◽

K.G. Warren

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Urinary Incontinence ◽

Chronic Fatigue Syndrome ◽

Chronic Fatigue ◽

Health Related Quality ◽

Fatigue Syndrome ◽

Related Quality ◽

Health Related

This study examined associations between comorbidity and health-related quality of life (HRQL) in people with multiple sclerosis (MS). Data were derived from the Canadian Community Health Survey (CCHS) Cycle 1.1, a cross-sectional survey conducted by Statistics Canada. A nationally representative sample of community-dwelling Canadians was interviewed to determine whether they had been diagnosed with various chronic conditions. Participants were also administered the Health Utilities Index Mark 3 (HUI3) questionnaire to evaluate HRQL. Of the 131,535 participants, 335 reported having MS. Comorbidities listed by at least 10% of respondents with MS were assessed for their relation to HRQL, with age, sex, education, marital status, income, and number of comorbidities included as covariates. Respondents averaged 1.6 comorbidities. Eight comorbidities were experienced by at least 10% of respondents: back problems (35%), nonfood allergies (29%), urinary incontinence (28%), arthritis (26%), hypertension (17%), chronic fatigue syndrome (16%), depression (16%), and migraine (14%). Differences in HRQL between people with and without urinary incontinence, arthritis, hypertension, chronic fatigue syndrome, and depression were either clinically important or statistically significant at the .05 level in bivariate analyses. Only urinary incontinence and depression, however, were negatively associated with HRQL in a multivariate analysis, which explained 26% of the variance. Lower levels of education and receiving social assistance were also negatively associated with HRQL, with social assistance contributing more to the variance in HRQL than either comorbidity.

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