Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study

Abstract Background Urinary incontinence (UI) is a common and debilitating condition among people with multiple sclerosis (MS) and is more prevalent among women. Over the past decade, numerous studies have investigated the effects of pelvic floor muscle training (PFMT) as a treatment for UI in peopl...

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Main Authors: Atieh Nazem, Shabnam ShahAli, Mehdi Dadgoo, Holakoo Mohsenifar, Ismail Ebrahimi Takamjani, Laleh Abadi Marand
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Trials
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Online Access:https://doi.org/10.1186/s13063-025-08721-0
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author Atieh Nazem
Shabnam ShahAli
Mehdi Dadgoo
Holakoo Mohsenifar
Ismail Ebrahimi Takamjani
Laleh Abadi Marand
author_facet Atieh Nazem
Shabnam ShahAli
Mehdi Dadgoo
Holakoo Mohsenifar
Ismail Ebrahimi Takamjani
Laleh Abadi Marand
author_sort Atieh Nazem
collection DOAJ
description Abstract Background Urinary incontinence (UI) is a common and debilitating condition among people with multiple sclerosis (MS) and is more prevalent among women. Over the past decade, numerous studies have investigated the effects of pelvic floor muscle training (PFMT) as a treatment for UI in people with MS. MS negatively impacts pulmonary function even in the early stages of the disease and people with MS may experience respiratory muscle weakness. Considering the synergy between the pelvic floor muscle (PFM) and respiratory muscles, this trial will evaluate the effects of PFMT and breathing exercises on PFM activity and strength, diaphragm activity, and urinary symptoms in women with MS who experience UI. Methods Fifty women with MS and UI will participate in this parallel randomized controlled trial, comprising 32 treatment sessions. The intervention group consists of PFMT and breathing exercises, and the control group includes PFMT. The severity of UI symptoms, PFM activity, diaphragm activity, and PFM strength will be evaluated using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, ultrasound imaging, and modified Oxford grading scale, respectively before and after the intervention. Discussion The current trial is designed to examine the effects of a combined exercise program for UI in women with MS. It is hypothesized that using breathing exercises in conjunction with PFM exercises will improve patient symptoms compared to PFMT alone. Trial registration The trial was registered in the Iranian Registry of Clinical Trials with code IRCT20180916041051N3 and was approved on 23 May 2024. Graphical Abstract
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spelling doaj-art-5b502fb8fea74357ab5ba609502367952025-01-19T12:37:57ZengBMCTrials1745-62152025-01-0126111110.1186/s13063-025-08721-0Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial studyAtieh Nazem0Shabnam ShahAli1Mehdi Dadgoo2Holakoo Mohsenifar3Ismail Ebrahimi Takamjani4Laleh Abadi Marand5Iranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesIranian Center of Excellence in Physiotherapy, Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical SciencesNeuromusculoskeletal Rehabilitation Research Center, University of Social Welfare and Rehabilitation SciencesAbstract Background Urinary incontinence (UI) is a common and debilitating condition among people with multiple sclerosis (MS) and is more prevalent among women. Over the past decade, numerous studies have investigated the effects of pelvic floor muscle training (PFMT) as a treatment for UI in people with MS. MS negatively impacts pulmonary function even in the early stages of the disease and people with MS may experience respiratory muscle weakness. Considering the synergy between the pelvic floor muscle (PFM) and respiratory muscles, this trial will evaluate the effects of PFMT and breathing exercises on PFM activity and strength, diaphragm activity, and urinary symptoms in women with MS who experience UI. Methods Fifty women with MS and UI will participate in this parallel randomized controlled trial, comprising 32 treatment sessions. The intervention group consists of PFMT and breathing exercises, and the control group includes PFMT. The severity of UI symptoms, PFM activity, diaphragm activity, and PFM strength will be evaluated using the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form, ultrasound imaging, and modified Oxford grading scale, respectively before and after the intervention. Discussion The current trial is designed to examine the effects of a combined exercise program for UI in women with MS. It is hypothesized that using breathing exercises in conjunction with PFM exercises will improve patient symptoms compared to PFMT alone. Trial registration The trial was registered in the Iranian Registry of Clinical Trials with code IRCT20180916041051N3 and was approved on 23 May 2024. Graphical Abstracthttps://doi.org/10.1186/s13063-025-08721-0Multiple sclerosisUrinary incontinencePelvic floor muscleExerciseBreathing exercisePhysiotherapy
spellingShingle Atieh Nazem
Shabnam ShahAli
Mehdi Dadgoo
Holakoo Mohsenifar
Ismail Ebrahimi Takamjani
Laleh Abadi Marand
Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study
Trials
Multiple sclerosis
Urinary incontinence
Pelvic floor muscle
Exercise
Breathing exercise
Physiotherapy
title Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study
title_full Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study
title_fullStr Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study
title_full_unstemmed Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study
title_short Effectiveness of breathing exercises on urinary symptoms, muscle activity, and strength in women with multiple sclerosis and urinary incontinence—a study protocol for a randomized controlled trial study
title_sort effectiveness of breathing exercises on urinary symptoms muscle activity and strength in women with multiple sclerosis and urinary incontinence a study protocol for a randomized controlled trial study
topic Multiple sclerosis
Urinary incontinence
Pelvic floor muscle
Exercise
Breathing exercise
Physiotherapy
url https://doi.org/10.1186/s13063-025-08721-0
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