The relationship between bladder functions, pelvic floor muscle strength, fall, and fatigue in multiple sclerosis

Tezeren H. C., KESER İ., ŞEN İ., Tuncer A.

Multiple Sclerosis and Related Disorders, vol.79, 2023 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 79
  • Publication Date: 2023
  • Doi Number: 10.1016/j.msard.2023.105013
  • Journal Name: Multiple Sclerosis and Related Disorders
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, MEDLINE
  • Keywords: Electromyography biofeedback, Fall, Lower urinary tract symptom, Multiple sclerosis
  • Hacettepe University Affiliated: Yes


Background: The aim of this study was to determine the relationship between the severity of bladder functions, fatigue, quality of life (QoL), fall, and pelvic floor muscle strength in patients with Multiple Sclerosis (PwMS). Methods: Patients were divided into two groups according to their Expanded Disability Status Scale (EDSS) bladder scores as Group 1 (EDSS bladder score 0–1, mildly affected group, n = 25) and Group 2 (EDSS bladder score 2–3–4, moderate and severely affected group, n = 21). Pelvic floor muscle (PFM) strength (EMG-Biofeedback device), fear of fall (Fall Efficacy Scale (FES-1)), fatigue (Fatigue Severity Scale (FSS)), QoL (Urogenital Distress Inventory-short form (UDI-6), and Incontinence Impact Questionnaire-short form (IIQ-7)) were evaluated. Results: 46 female patients diagnosed with MS were included in this study. No significant differences in baseline characteristics were seen between the groups except age. EDSS bladder score were 1 (0–1) and 3 (2–4), EMG-Biofeedback score were 79,5 ± 8,11 and 41,7 ± 5,48, FSS score were 38,7 ± 2,80 and 54±2,20, FES-I score were 16,9 ± 2,15 and 40,2 ± 7,39, UDI-6 score were 4,24±0,47 and 8,42±0,64, IIQ-7 score were 3,64±0,86 and 18,2 ± 1,42 in Group 1 and Group 2. As a result of statistical analysis, significant differences were found in less fatigue and fall, higher PFM strength and better QoL with mildly affected PwMS (p<0,05). Conclusion: There was a significant difference in terms of bladder function level in PFM strength, fall, fatigue and QoL between the mildly affected group and the moderate and severely affected group.