The Effect of DNS-Based Training Combined With PFMT on LUTS and Pelvic Floor Functions in Women With MS

Ondokuz Mayıs University

Status: Completed

Conditions: Lower Urinary Track Symptoms; Multiple Sclerosis; Women With Multiple Sclerosis; Pelvic Floor Disorder

Treatments: Other: Pelvic Floor Muscle Training combined with Dynamic Neuromuscular Stabilization (PFMT+DNS); Other: Pelvic Floor Muscle Training (PFMT)

Study type: Interventional

Funder types: Other

Identifiers

NCT07166809

2022/554

Details and patient eligibility

About

The goal of this randomized controlled trial is to investigate whether adding Dynamic Neuromuscular Stabilization (DNS)-based training to Pelvic Floor Muscle Training (PFMT) can improve lower urinary tract symptoms (LUTS) and pelvic floor functions in women with multiple sclerosis (MS), aged 28-54 years.

The main questions it aims to answer are:

Does DNS combined with PFMT improve lower urinary tract symptoms more effectively than PFMT alone?

Does DNS combined with PFMT enhance pelvic floor muscle function more effectively than PFMT alone?

Researchers will compare PFMT alone versus PFMT combined with DNS-based stabilization exercises to see if DNS provides additional benefits.

Participants will:

Perform an 8-week remotely monitored Pelvic Floor Muscle Training program.

In the DNS+PFMT group, complete supervised Dynamic Neuromuscular Stabilization exercises three times a week.

Undergo assessments including:

Urinary Symptom Profile questionnaire and uroflowmetry for objective evaluation of lower urinary tract symptoms,

International Consultation on Incontinence Questionnaire-Short Form,

Overactive Bladder Questionnaire (8-item version),

Vaginal palpation using the PERFECT (Power, Endurance, Repetitions, Fast contractions, Every Contraction Timed) scheme,

Electromyography (muscle electrical activity measurement) for pelvic floor muscles,

Magnetic Resonance Imaging (MRI) for diaphragm function evaluation.

Enrollment: 24 patients

Sex: Female

Ages: 18 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Aged 18-65 years
• Diagnosis of multiple sclerosis with an Expanded Disability Status Scale (EDSS) score below 6
• Pelvic floor muscle strength greater than grade 1 according to the Modified Oxford Scale (MOS)
• No pelvic floor muscle training received in the previous six months

Exclusion criteria

• Multiple sclerosis relapse within the past month
• Pregnant or within six months postpartum
• Diagnosis of urinary tract infection
• Any medical condition that could interfere with participation

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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24 participants in 2 patient groups

PFMT

Active Comparator group

Description:

Participants in the PFMT group received only an 8-week remotely monitored pelvic floor muscle training program without additional DNS-based exercises.

Treatment:

Other: Pelvic Floor Muscle Training (PFMT)

PFMT+DNS

Experimental group

Description:

Participants in the PFMT+DNS group received the same 8-week remotely monitored pelvic floor muscle training program, in addition to supervised Dynamic Neuromuscular Stabilization exercises three times per week.

Treatment:

Other: Pelvic Floor Muscle Training (PFMT)

Other: Pelvic Floor Muscle Training combined with Dynamic Neuromuscular Stabilization (PFMT+DNS)