A comparative study on the effects of therapeutic exercise using swissball versus EMG biofeedback in MS patients with urinary incontinence

Document Type : Original Articles


1 Physical therapist, Department of Physical Therapy, Isfahan university of Medical Science, Isfahan, Iran.

2 Asistant Prof (MD) Department of Neurology, Isfahan university of Medical Science, Isfahan, Iran.

3 Student of Physical Therapy, Department of Physical Therapy, Isfahan University of Medical Sciences, Isfahan,Iran.



Abstract: Introduction: Multiple sclerosis is the most common progressive neurologic disorder in young adults. This disorder results in destruction of neural axons and causes various problems including urinary dysfunction. Urinary dysfunctions have a profound effect on different aspects of patients' daily life including negative effects on their quality of life.  Materials and methods: It was a Single-blind, prospective, non-randomized and quisy-experimental study. This study was conducted in Esfahan's rehabilitation college-affiliated clinics during 2008 and 2009. 42 MS patients with urinary incontinence randomly assigned to one of two groups. Subjects in one group were taught to perform swissball exercises for 10 sessions and for the patients of the other group, EMG biofeedback was used for 10 sessions. Evaluation of therapeutic effects was performed in 3 points of time: Before and after treatment and 1 month later (for follow up). ICIQUISF and SF-36 questionnaires were used for determining the amount of urinary incontinence and evaluating quality of life respectively. P.I.I.Q questionnaire was used for studying the effects of urinary incontinence on patients' Activities of Daily Living. Statistical analysis of data was preformed via SPSS13 software. Results: In both groups, Meaningful differences in the amount of urinary incontinence as well as in quality of life (physically and mentally) were observed before and after the treatment (p<0/05).   Conclusion: The obtained results showed that swissball exercises and EMG biofeedback are able to decrease amount of urinary incontinence, and to improve patients’ quality of life and decrease effects of incontinence on patients' ADL. swissball exercises, however, have more long-term effects on decreasing amount of urinary incontinence and improving physical quality of life, while biofeedback was more effective in improving patients' ADL. Key words: multiple sclerosis, urinary incontinence, swissball exercises, biofeedback.