Effect of integrated Yoga on neurogenic bladder dysfunction in patients with multiple sclerosis-A prospective observational case series

Abstract

Background: Neurogenic bladder dysfunction (NBD) is a common distressful symptom in multiple sclerosis (MS) affecting quality of life. Yoga has been widely used in treating various symptoms of patients with MS.

Objectives: To evaluate the effect of integrated Yoga for NBD in patients with MS as an adjunct to standard medical care.

Design: This open arm, pre-post study design assessed the outcome measures at base line and after 21 days of integrated Yoga intervention.

Setting: study was conducted at the center for neurological rehabilitation at KWA-Klinik Stift Rottal in Bad Griesbach, Germany. Eleven MS patients with NBD (mean age 46.7±11.24 years) with mean duration 17.2 years volunteered to participate in the study.

Interventions: integrated Yoga which includes preparatory yogic loosening and breathing practices, Nadishuddi pranayama (alternate nostril breathing), moola bandha (anal lock), kapalbhati (rapid nostril breathing) and deep relaxation technique was given for 2h per day for continuous 21 days.

Outcome measures: ultrasound scanning for post void residual urine volume (PVR), micturition check list (MCL), incontinence impact questionnaire-7 (IIQ-7) andurogenital distress inventory-6 (UDI-6) were used.

Results: Paired sample t-test showed significant improvement in post void residual urine (62.34%, p<0.05), scores on micturition frequency checklist (25%, p<0.05), incontinence impact questionnaire-7 (32.77%, p<0.05) and uro-genital distress inventory-6 (26.33%, p<0.05).

Conclusion: This study points to the safety and effectiveness of integrated Yoga for bladder symptoms as an adjunct to standard care in multiple sclerosis patients with neurogenic bladder dysfunction in Germany. Further trails are necessary to confirm these findings.