Comparison the effect of pelvic floor muscle exercise and acupressure on urinary incontinence in women with multiple sclerosis

Comparing the effects of pelvic floor muscle exercise and acupressure on urinary incontinence in women with multiple sclerosis, Department of Special Diseases, Ali Ibn Abitaleb Educational and Medical Center, Rafsanjan, 2025

A controlled, triple-blind, purposive sampling clinical trial based on inclusion criteria and then a minimization randomization method, on 96 patients in three groups: Kegel exercise, acupressure, and control.

Study location: MS ward of Ali Ibn Abi Taleb Hospital in Rafsanjan; Study population: All women with MS in Rafsanjan; Type of blinding: Triple blind; Method of blinding: Participants' lack of knowledge of the exact impact of interventions on urinary incontinence, Assessor's lack of knowledge of the type of interventions performed by individuals at home when completing the questionnaire, Use of the letters A, B, C to identify groups to the analyst instead of the names of interventions

Inclusion criteria: Age 18 to 65 years; Having the physical and cognitive ability to learn and perform interventions; Having at least one month since starting or changing medications that affect urinary incontinence. Exclusion criteria: concurrent use of common complementary therapies; pregnancy; acute or recurrent stage of the disease; urinary tract infection; within 6 months after vaginal delivery; history of third- and fourth-degree lacerations during vaginal delivery

Intervention group 1: Daily pelvic floor muscle exercise in 3 sets of 10 by the individual for 8 weeks. Intervention group 2: Acupressure by applying constant and continuous pressure with the thumb or other fingers of the individual on the K3 point for 30 minutes three days a week for 8 weeks. Control group: Will not receive any intervention other than routine treatments.

Urinary incontinence severity

After obtaining the necessary permits, the researchers will first select 96 women (32 in each group) from among the total number of women with multiple sclerosis who have a file at the Center for Special Diseases of Ali Ibn Abi Taleb Hospital in Rafsanjan, using a purposive sampling method based on the inclusion criteria. Eligible participants will then be assigned to groups using the minimization randomization method, according to the levels of incontinence severity. The pre-test will be conducted at four levels: mild (score 1–5), moderate (score 6–12), severe (score 13–18), and very severe (score 19–21), across three groups: intervention with Kegel exercises, intervention with acupressure, and a control group. The first participant at each severity level will be assigned to one of the study groups by random drawing through a sealed envelope. The next participant with the same severity of incontinence will be randomly assigned to one of the two remaining groups. The third participant with the same severity will be assigned to the last group. This process will continue until the desired sample size is achieved.

Participants will not be informed that the interventions are specifically intended to affect urinary incontinence. The evaluator will remain unaware of the intervention assigned to each participant when completing the questionnaires. To ensure blinding of the data analyst, the study groups will be identified by the letters A, B, and C rather than by the intervention names.