The effect of dynamic neuromuscular stabilization exercises on stress urinary incontinence in women with multiple sclerosis: a randomized clinical trial

Abstract

Objective: Multiple sclerosis (MS) is a common central nervous system disorder, with stress urinary incontinence (SUI) as a significant symptom. Currently, there is limited evidence regarding the effectiveness of dynamic neuromuscular stabilization (DNS) exercises in managing SUI symptoms in individuals with MS. This study aimed to explore the impact of DNS exercises on SUI in women diagnosed with MS. Methods: In this double-blind clinical trial study, 28 women with MS and SUI, aged 18-55 years, were randomly assigned to experimental (n = 14) and control (n = 14) groups. The experimental group participated in DNS exercises, while the control group performed pelvic floor muscles (PFM) contraction exercises for six weeks, with two sessions each week. The primary outcome measures were PFM strength, the severity of urinary incontinence (UI), and quality of life (QoL) assessed by the Modified Oxford Grading System, the severity index, and the Lower Urinary Tract Symptoms Quality of Life (LUTS QoL) questionnaire respectively. Results: The trend of changes in PFM strength and QoL was not significant in the two groups (P > 0.05), while the trend of changes in severity index was significant (P < 0.05). Regardless of the study groups, the average change in the PFM strength and QoL during six weeks of intervention was significant (P < 0.05). Conclusions: DNS exercises and PFM exercises are both effective for improving PFM strength, reducing the severity of UI, and enhancing the QoL in women with MS and SUI. However, the DNS method produces faster results in reducing the severity of UI compared to the PFM contraction exercise.