EFFICACY OF INTEGRATED YOGA ON NEUROGENIC BLADDER DYSFUNCTION IN   MULTIPLE SCLEROSIS
By
Dr. NEETINAKUMAR PATIL

Background: Neurogenic bladder dysfunction (NBD) is a common distressful symptom limiting multiple sclerosis (MS) patient’s social life. Yoga has been shown to reduce fatigue and spasticity in MS patients and achieve autonomic stability in normal healthy volunteers.
Objectives: To assess the efficacy of integrated Yoga therapy on neurogenic bladder dysfunction in   MS patients.
Design: This open arm study with a pre-post design assessed the outcome measures at base line and after 21 days of Yoga intervention.
Setting: Study was conducted at the center for neurological rehabilitation at KWA-Klinik Stift Rottal in Bad Griesbach Germany. Eleven patients (10 females, 1 male, age 46.7 ± 11.24 years) with neurogenic bladder dysfunction due to established diagnosis of MS (mean duration of MS= 17.2 years) volunteered to participate in the study.
Interventions: Yoga intervention included preparatory yogic loosening and breathing practices, Nadishuddi pranayama (alternate nostril breathing), Moola bandha (yogic pelvic floor exercise-Anal lock), kapalbhatii (rapid nostril breathing) and deep relaxation technique.  Patients underwent Yoga training for 2 hours per day.
Outcome measures:
Ultrasound scanning for post residual urine volume (PVR), micturition check list (MCL), incontinence impact questionnaire-7 (IIQ-7) and urogenital distress Inventory-6 (UDI-6).
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: Yoga practices help in reducing post void residual urine volume, urinary frequency, and distress in MS patients with neurogenic bladder dysfunction.