The Effect of Reflexology and Pelvic Floor Muscle Exercises (Kegel) on Urinary Incontinence in MS Patients

Study Overview
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Brief Summary
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The research was carried out as experiment, control group, pretest-posttest model and single-blind. The population of the study consisted of MS patients who applied to OMU (Ondokuz Mayıs University) Neurology Service and Neurology Outpatient Clinic between March 2020 and February 2022. Fifteen patients who met the inclusion criteria were included in the study. Patients were divided into reflexology, pelvic floor muscle exercise and control groups. The control group was not intervened, only data collection tools were applied.

Detailed Description
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The research was carried out as experiment, control group, pretest-posttest model and single-blind. The population of the study consisted of MS patients who applied to OMU (Ondokuz Mayıs University) Neurology Service and Neurology Outpatient Clinic between March 2020 and February 2022. Fifteen patients who met the inclusion criteria were included in the study. Patients were divided into reflexology, pelvic floor muscle exercise and control groups. The control group was not intervened, only data collection tools were applied. reflexology intervention The reflexology application was carried out in a separate and quiet room, on a stretcher/bed where the patient could lie down, by adjusting the temperature so that they would not feel cold/sweaty. First, the feet were cleaned with a warm, damp cotton towel. Odorless, room temperature baby oil was used to provide lubricity during the reflexology application. The reflexology protocol was started with the right foot. First of all, rotation, vibration, etc. are applied to the ankle and ankle areas. relaxation techniques were applied for 2 minutes. Afterwards, reflexology massage was applied to the spinal cord, brain, pituitary areas, kidney, ureter and bladder areas with appropriate techniques. The session was concluded with solar plexus compression and relaxation maneuvers. The same protocol was applied in the left foot. Immediately after each reflexology session, the patient was allowed to drink 1 glass (200 ml) of water to accelerate the excretion of toxic products. Reflexology session was completed in 40 minutes for both feet. Foot reflexology was applied to the reflexology group twice a week (40 minutes for both feet) for a total of 4 weeks. Pelvic floor muscle exercise (Kegel) application In the Kegel exercise group, the patients were taught the Kegel exercise at the first interview, and it was provided to be done under the guidance of the researcher. Afterward, they were asked to apply at least three times a day for four weeks, and a reminder SMS was sent to the patients daily.

Official Title
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The Effect of Reflexology and Pelvic Floor Muscle Exercises (Kegel) on Urinary Incontinence in MS Patients

Conditions
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Multiple Sclerosis, Reflexology, Urinary Incontinence

Intervention / Treatment
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* Other: Reflexology and kegel exercises


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosed with MS at least 6 months ago, Having an EDSS of <5, Exclusion Criteria: To have wound on foots, varicose veins, etc. history of fractures causing loss of function, nail fungus, pregnancy, presence of acute infection To using any diuretic or incontinence medication, To have a curettage or pregnancy history in the last 6 months

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Median score distributions of the reflexology groups, ICIQ-SF, IQOL and ISI<br> | Other: Reflexology and kegel exercises<br>* Reflexology is specific to a foot massage, and ıt can use different symptoms for patients. Kegel exercise is specific an activities and ıt can used for urinary incontinence<br>|
| Active Comparator: Median score distributions of the kegel groups, ICIQ-SF, IQOL and ISI<br> | Other: Reflexology and kegel exercises<br>* Reflexology is specific to a foot massage, and ıt can use different symptoms for patients. Kegel exercise is specific an activities and ıt can used for urinary incontinence<br>|
| Active Comparator: Median score distributions of the control groups, ICIQ-SF, IQOL and ISI<br> | Other: Reflexology and kegel exercises<br>* Reflexology is specific to a foot massage, and ıt can use different symptoms for patients. Kegel exercise is specific an activities and ıt can used for urinary incontinence<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Index of severity incontinence (ISI) | The total score is between 0-12. A score of 0 indicates that there is no incontinence. The scale score is then categorized into 4 different levels of incontinence severity: 1-2: mild, 3-6: moderate, 8-9: severe, 10-12: very serious. | 4 weeks | 
| nternational Consultation on Incontinence Questionnaire Short Form(ICIQ-SF) | The scores that can be obtained from the scale range from 0 to 21; A low score indicates that urinary incontinence has little effect on quality of life, while a high score indicates that it affects the quality of life very much. | 4 weeks | 
| Incontinence quality of life (IQOL) | The total score ranges from 0 to 100. High scores indicate better quality of life than low scores. | 4 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multiple sclerosis, Nurses, Complementary Therapies, Urinary Incontinence, Reflexology