Evaluation of the Influence of a Core Muscle Control-Based Rehabilitation Program Patients With Multiple Sclerosis

European University

Status: Enrolling

Conditions: Pelvic Floor Disorders; Multiple Sclerosis; Incontinence, Urinary

Treatments: Other: rehabilitation programme based on motor control of core muscles

Study type: Interventional

Funder types: Other

Identifiers

NCT06384716

CEB

Details and patient eligibility

About

Given the structural relationship of the CORE as a whole, in this study we propose an intervention based on the global motor control of all the structures that make up the CORE to assess its effectiveness on urinary incontinence, sexual dysfunction and balance, as well as its relationship with respiratory function. According to our hypothesis, a global intervention could also be taken into account during conventional treatment in the future, helping to prevent genitourinary dysfunctions derived from alterations in motor control.

Full description

Main objective:

To establish the effect of core motor control training on pelvic floor functionality in patients with multiple sclerosis.

Specific objective: To assess the effect of core motor control training on urinary incontinence.

• To assess the effect of core motor control training on urinary incontinence in patients with multiple sclerosis.
• To assess the effect of core motor control training on quality of life in patients with multiple sclerosis.
• To assess the effect of core motor control training on sexual dysfunction in patients with multiple sclerosis.
• To assess the effect of core motor control training on balance in patients with multiple sclerosis.
• To test the relationship between respiratory functionality and pelvic floor dysfunctions in patients with multiple sclerosis.

Enrollment: 32 estimated patients

Sex: All

Ages: 18 to 70 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• • Age between 18 and 70 years.
• Confirmed diagnosis of Multiple Sclerosis based on McDonald criteria, with an evolution time of more than two years (remitting or progressive) (24).
• Multiple Sclerosis Disability Status Scale (EDSS) score between 2 (minimal disability in one of the functional systems), and 7.5 (inability to take more than a few steps. Limited to wheelchair and transfer support. Ability to move the chair, but not all day if the chair is conventional and lacks a motor) (25, 26).
• Stable medical treatment for at least six months prior to surgery (26).
• Absence of cognitive impairment, with ability to understand instructions and score 24 or higher on the Minimental Test (27).
• Urinary incontinence as a consequence of neurological involvement.

Exclusion criteria

• • Diagnosis of another neurological disease or musculoskeletal disorder other than MS.
• Diagnosis of any cardiovascular, respiratory, genitourinary, metabolic or other conditions that may interfere with this study.
• Having presented urinary incontinence prior to the diagnosis of MS.
• Have suffered an exacerbation or hospitalisation in the last 3 months before starting the assessment protocol, or during the therapeutic intervention process.
• Have received a course of intravenous or oral steroids 6 months prior to the start of the assessment protocol and within the intervention period of the study duration.

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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32 participants in 2 patient groups

Experimental Group 1

Experimental group

Description:

The intervention group will come to receive the treatment focused on training the motor control of the CORE. This intervention will consist of two sessions per week in which different levels of intervention will be established: 1. - First week: Sensitisation and voluntary work of the pelvic floor musculature without increasing the increase in intra-abdominal pressure. 2. - Second week: Work on respiratory motor control and activation of the pelvic floor. 3. - Third and fourth week: Motor control work with progressive increase in intra-abdominal pressure. 4. - Fifth and sixth week: Work on dynamic motor control in dual-task situations. 5. - Seventh and eighth week: Core motor control work in functional activities.

Treatment:

Other: rehabilitation programme based on motor control of core muscles

Control group

No Intervention group

Description:

The control group will be evaluated before and after 8 weeks and will continue with their usual treatment.