The goal of this randomized controlled trial is to investigate whether adding Dynamic Neuromuscular Stabilization (DNS)-based training to Pelvic Floor Muscle Training (PFMT) can improve lower urinary tract symptoms (LUTS) and pelvic floor functions in women with multiple sclerosis (MS), aged 28-54 years. The main questions it aims to answer are: Does DNS combined with PFMT improve lower urinary tract symptoms more effectively than PFMT alone? Does DNS combined with PFMT enhance pelvic floor muscle function more effectively than PFMT alone? Researchers will compare PFMT alone versus PFMT combined with DNS-based stabilization exercises to see if DNS provides additional benefits. Participants will: Perform an 8-week remotely monitored Pelvic Floor Muscle Training program. In the DNS+PFMT group, complete supervised Dynamic Neuromuscular Stabilization exercises three times a week. Undergo assessments including: Urinary Symptom Profile questionnaire, International Consultation on Incontinence Questionnaire-Short Form, Overactive Bladder Questionnaire (8-item version), Vaginal palpation using the PERFECT (Power, Endurance, Repetitions, Fast contractions, Every Contraction Timed) scheme, Electromyography (muscle electrical activity measurement) for pelvic floor muscles evaluation.
Age range
18 Years – 65 Years
Sex
FEMALE
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Lower urinary tract symptoms (LUTS) severity
Timeframe: Baseline and 8 weeks after intervention
Urinary incontinence severity and impact on quality of life
Timeframe: baseline and 8 weeks
Overactive bladder symptoms
Timeframe: Baseline and 8 weeks
Pelvic Floor Muscle Function - Vaginal Palpation
Timeframe: Baseline and 8 weeks
Pelvic floor muscle function - Electromyography (EMG)
Timeframe: Baseline and 8 weeks