Raheem Osama M Abdel, Abdel-Hady Doaa A
Department of physical therapy for Neurology, Faculty of Physical Therapy, Deraya University, EL-Mina, Egypt.
Department of physical therapy for women's health, Faculty of Physical Therapy, Deraya University, EL-Mina, Egypt.
Neurol Sci. 2025 Mar;46(3):1291-1299. doi: 10.1007/s10072-024-07788-y. Epub 2024 Oct 21.
Overactive bladder (OAB) is a common clinical presentation in patients with multiple sclerosis.
The purpose of this study was to compare the effects of transcranial magnetic stimulation (TMS) and biofeedback on overactive bladder in patients with multiple sclerosis.
This research included 45 individuals with multiple sclerosis of both sexes. We randomly divided them into three equal groups (A, B, and C). Patients in group A got biofeedback training and pelvic floor exercise (PFME); patients in group B had transcranial magnetic treatment and PFME; and patients in group C had PFME. Urodynamic measurements were utilized to determine bladder parameters (detrusor pressure at maximum flow rate, bladder volume at initial desire to empty, maximum cystometric capacity, detrusor pressure, and maximum flow rate) for all groups before and after a six-week training interval (the end of therapy).
There was a statistically significant improvement in all urodynamic measurement parameters within the groups (Groups A, B and C). Except for the maximal cystometric capacity and detrusor pressure were non-significant improvement in B before and after therapy. However, there was no significant difference between the three groups following therapy.
Transcranial magnetic stimulation and biofeedback improved bladder function in patients with multiple sclerosis. These approaches have a high level of safety and effectiveness, but EMG biofeedback has superiority.
膀胱过度活动症（OAB）是多发性硬化症患者常见的临床表现。
本研究旨在比较经颅磁刺激（TMS）和生物反馈对多发性硬化症患者膀胱过度活动症的影响。
本研究纳入了45名男女多发性硬化症患者。我们将他们随机分为三组（A组、B组和C组），每组人数相等。A组患者接受生物反馈训练和盆底肌锻炼（PFME）；B组患者接受经颅磁治疗和PFME；C组患者仅接受PFME。在为期六周的训练间隔（治疗结束时）前后，对所有组别的患者进行尿动力学测量，以确定膀胱参数（最大尿流率时的逼尿肌压力、初始排尿欲望时的膀胱容量、最大膀胱测压容量、逼尿肌压力和最大尿流率）。
各组（A组、B组和C组）的所有尿动力学测量参数均有统计学意义的改善。除B组治疗前后最大膀胱测压容量和逼尿肌压力改善不显著外。然而，治疗后三组之间无显著差异。
经颅磁刺激和生物反馈改善了多发性硬化症患者的膀胱功能。这些方法具有较高的安全性和有效性，但肌电图生物反馈具有优越性。
