Article

The objective of this study was to investigate the effects of two
programs for strengthening the pelvic floor on the urinary incontinence of
patients with multiple sclerosis (MS). DESIGN: This is a prospective study of the
clinical trial type, monitored for 6 mos, in which 24 women in the moderate stage
of MS participated in a program of exercises for strengthening the pelvic
floor-associated (experimental group) or not (control group) with electrotherapy.
The variables analyzed were as follows: quality-of-life, overactivity of the
bladder, perineal contraction, and level of anxiety and depression. The
statistical procedures involved multivariate analyses of repeated measurements,
with a significance of 5%. RESULTS: Initial homogeneity being observed in the
anthropometric and clinical variables, both protocols resulted in improvements in
quality-of-life (P = 0.001), overactive bladder (P = 0.001), perineal contraction
(P = 0.004), and level of anxiety (P = 0.001) and depression (P = 0.001), in
relation to the initial comparison. The association of electrotherapy with
strengthening exercises increased the improvement of the patients regarding
overactive bladder (P = 0.039) and perineal contraction (P = 0.001), in
comparison with the control group. CONCLUSIONS: The results reinforce the benefit
of exercises for strengthening the musculature of the pelvic floor in women with
overactive bladder in MS and demonstrate a potential of the action when
associated with electrotherapy. TO CLAIM CME CREDITS: Complete the
self-assessment activity and evaluation online at
http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this
article, the reader should be able to: (1) Identify common dysfunctions of the
lower urinary tract in women with multiple sclerosis; (2) Discuss the
relationship between quality-of-life, level of anxiety and depression, degree of
perineal contraction, and overactive bladder; and (3) Recognize the benefits
promoted by physical therapy for strengthening the pelvic floor in patients with
multiple sclerosis. LEVEL: Advanced ACCREDITATION: : The Association of Academic
Physiatrists is accredited by the Accreditation Council for Continuing Medical
Education to provide continuing medical education for physicians. The Association
of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA
Category 1 Credit(s). Physicians should only claim credit commensurate with the
extent of their participation in the activity.

Langue : ANGLAIS