The Efficiency of Rehabilitation Therapy in Patients Diagnosed with Neurogenic Bladder: A Systematic Review

Medicina, 2024 · DOI: https://doi.org/10.3390/medicina60071152 · Published: July 17, 2024

Simple Explanation

This review examines rehabilitation methods for treating neurogenic bladder, a common pelvic floor disorder in patients with conditions like multiple sclerosis, stroke, and spinal cord injury. It focuses on physical therapy interventions such as pelvic floor muscle training and electrostimulation. The study analyzes the effectiveness of noninvasive treatments in reducing urinary incontinence and improving patients’ quality of life. It also looks at the assessment methods used to evaluate neurogenic bladder issues. The review included eleven articles that analyzed the effects of different forms of physical therapy on 364 patients diagnosed with neurogenic bladder.

Study Duration

Not specified

Participants

364 patients diagnosed with neurogenic bladder

Evidence Level

Systematic Review of RCTs and Clinical Trials

Key Findings

1
Electrostimulation, combined with or without PFMT, can significantly enhance health-related quality of life.
2
Physical therapy is an effective method to reduce the severity of urinary incontinence.
3
TTNS induced statistically significant improvements in bladder function compared to placebo stimulation. Participants with anatomically normal lower urinary tracts were the only ones benefiting from TTNS.

Research Summary

This comprehensive review assesses the effectiveness of physiotherapy treatments, including pelvic floor muscle training (PFMT) and electrostimulation, compared to placebo, drug therapy, or unguided PFMT for neurogenic bladder. The analysis of 11 studies provided compelling evidence supporting the positive impact of non-invasive treatment options for managing neurogenic bladder in patients with neurological conditions. The review highlights the importance of both subjective patient-reported outcomes and objective clinical measurements in guiding treatment decisions and enhancing patient care.

Practical Implications

Clinical Practice

Physical intervention can be a practical and efficacious therapeutic modality without side effects, reducing the severity of urinary incontinence and enhancing patients’ overall quality of life.

Future Research

Further research is needed to identify long-term protocols for PFMT and to explore the potential of high-intensity-focused electromagnetic (HIFEM) therapy in neurologically impaired patients.

Multidisciplinary Approach

A multidisciplinary approach in inpatient rehab facilities is crucial for achieving or maintaining functional autonomy for patients with neurogenic bladder.

Study Limitations

1
Limited scope by only including six scientific databases.
2
Significant heterogeneity due to the lack of inclusion/exclusion criteria based on outcome measures.
3
Small number of heterogeneous patients in the included studies.

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