{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T16:11:28Z","timestamp":1791648688854,"version":"4.3.4"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T00:00:00Z","timestamp":1736726400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Multiple sclerosis (MS) is a debilitating autoimmune disease that mostly affects women.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>In this study we evaluated the relationship of pelvic muscle strengths with urinary incontinence and quality of life in women with MS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and methods<\/jats:title><jats:p>In this cross-sectional study 87 women with MS were recruited. Data collected using a demographic questionnaire, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and Quality of Life Questionnaire (QOL-SF-36). A perineometer was used to measure the strengths of pelvic muscle. Data analyzed using Pearson correlation test, and multiple linear regression tests.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a positive correlation between pelvic muscle strengths with all domains of quality of life except for body pain and role limitations due to emotional problems. A significant inverse correlation was found between urinary incontinence and all domains of quality of life except for body pain. Also, an inverse correlation was found between muscle strength and urinary incontinence (<jats:italic>r<\/jats:italic>\u202f=\u202f\u22120.838, <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001). A one-unit increase in the quality of physical life was associated with a 0.15-unit increase in the strengths of pelvic floor muscles (<jats:italic>p<\/jats:italic>\u202f=\u202f0.035). On the other hand, each additional year of marriage or disease duration significantly weakened pelvic floor muscles by 0.24 and 0.509\u202funits, respectively (<jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings showed that pelvic muscle strength, urinary incontinence, and quality of life were significantly interrelated among female patients with MS. An inverse correlation was also found between muscle strength and urinary incontinence. Duration of marriage and length of MS disease were inversely associated with the strength of the pelvic floor muscles. Health providers are recommended to educate MS patients on the importance of pelvic muscle strengths.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2024.1514157","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T05:10:54Z","timestamp":1736745054000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Strengths of pelvic floor muscles in women with multiple sclerosis and its relationship with urinary incontinence and quality of life"],"prefix":"10.3389","volume":"15","author":[{"given":"Poorandokht","family":"Afshari","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parvin","family":"Abedi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nastaran","family":"Majdinasab","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samaneh","family":"Tafakh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadhossein","family":"Haghighizadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,13]]},"reference":[{"key":"ref1","year":""},{"key":"ref2","article-title":"Multiple sclerosis","volume-title":"Current diagnosis and treatment in neurology","author":"Cree","year":"2007"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1586\/14737175.2013.865866","article-title":"Environmental factors in multiple sclerosis","volume":"13","author":"Ascherio","year":"2013","journal-title":"Expert Rev Neurother"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1816","DOI":"10.1177\/1352458520970841","article-title":"Rising prevalence of multiple sclerosis worldwide: insights from the atlas of MS","volume":"26","author":"Walton","year":"2020","journal-title":"Mult Scler J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1073278","DOI":"10.3389\/fpubh.2023.1073278","article-title":"Global, regional, and national burden of multiple sclerosis from 1990 to 2019: findings of global burden of disease study 2019","volume":"11","author":"Qian","year":"2023","journal-title":"Front Public Health"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1016\/S1474-4422(06)70581-6","article-title":"Sex ratio of multiple sclerosis in Canada: a longitudinal study","volume":"5","author":"Orton","year":"2006","journal-title":"Lancet Neurol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e0214738","DOI":"10.1371\/journal.pone.0214738","article-title":"Epidemiology of multiple sclerosis in Iran: a systematic review and meta-analysis","volume":"14","author":"Azimi","year":"2019","journal-title":"PLoS One"},{"key":"ref8","first-page":"175","article-title":"Multiple sclerosis review","volume":"37","author":"Goldenberg","year":"2012","journal-title":"PT"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1016\/j.apjtb.2016.03.009","article-title":"Multiple sclerosis: new insights and trends","volume":"6","author":"Koriem","year":"2016","journal-title":"Asian Pac J Trop Biomed"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"86","DOI":"10.5213\/inj.2012.16.2.86","article-title":"Prevalence of stress urinary incontinence in women with multiple sclerosis","volume":"16","author":"Murphy","year":"2012","journal-title":"Int Neurourol J"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"91","DOI":"10.7224\/1537-2073.2019-030","article-title":"Prevalence of lower urinary tract symptoms in people with multiple sclerosis","volume":"22","author":"Dandan","year":"2020","journal-title":"Int J MS Care"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1186\/s12883-019-1582-1","article-title":"The prevalence of lower urinary tract symptoms based on individual and clinical parameters in patients with multiple sclerosis","volume":"20","author":"Nazari","year":"2020","journal-title":"BMC Neurol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/S0090-4295(99)00495-1","article-title":"Treatment of overactive bladder: other drugs mechanisms","volume":"55","author":"Andersson","year":"2000","journal-title":"Urology"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"102746","DOI":"10.1016\/j.msard.2021.102746","article-title":"Multiple sclerosis does not affect the muscular strength of the pelvic floor during pregnancy a case control study","volume":"49","author":"Lourenco","year":"2021","journal-title":"Multiple Scler"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"1563","DOI":"10.1590\/S1807-59322011000900010","article-title":"A comparative study of pelvic floor muscle training in women with multiple sclerosis: its impact on lower urinary tract symptoms and quality of life","volume":"66","author":"Lucio","year":"2011","journal-title":"Clinics"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1007\/s00192-006-0131-9","article-title":"Quality of life in women with multiple sclerosis and overactive bladder syndrome","volume":"18","author":"Quarto","year":"2007","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"Tgompson","year":"2018","journal-title":"Lancet Neurol"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"322","DOI":"10.1002\/nau.20041","article-title":"ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence","volume":"23","author":"Avery","year":"2004","journal-title":"Neurourol Urodyn"},{"key":"ref19","first-page":"685","article-title":"Validity and reliability of the international consultation on incontinence questionnaire-urinary incontinence short form and its correlation with urodynamic findings","volume":"9","author":"Hajebrahimi","year":"2012","journal-title":"Urol J"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1097\/00005650-199206000-00002","article-title":"The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection","volume":"30","author":"Ware","year":"1992","journal-title":"Med Care"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1007\/s11136-004-1014-5","article-title":"The short form health survey (SF-36): translation and validation study of the Iranian version","volume":"14","author":"Montazer","year":"2005","journal-title":"Qual Life Res"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1111\/ene.13010","article-title":"Urinary incontinence in multiple sclerosis: prevalence, severity and impact on patients' quality of life","volume":"23","author":"Zeca","year":"2016","journal-title":"Eur J Neurol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"345","DOI":"10.2147\/JMDH.S244697","article-title":"Bladder dysfunction in Iranian patients with multiple sclerosis","volume":"13","author":"Azadvari","year":"2020","journal-title":"J Multidiscip Healthc"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e57010","DOI":"10.7759\/cureus.57010","article-title":"The prevalence and impact of urinary incontinence on multiple sclerosis patients in Taif City, Saudi Arabia","volume":"16","author":"Mubaraki","year":"2024","journal-title":"Cureus"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"480","DOI":"10.1177\/1352458509360040","article-title":"Fatigue, mood and quality of life improve in MS patients after progressive resistance training","volume":"16","author":"Dalgas","year":"2010","journal-title":"Multiple Scler J"},{"key":"ref26","first-page":"21","article-title":"The benefits of pelvic floor muscle training in people with multiple sclerosis and lower urinary tract dysfunction","volume":"103","author":"McClurg","year":"2008","journal-title":"J Assoc Chart Physiother Womens Health"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"20","DOI":"10.7224\/1537-2073.2012-052","article-title":"Pelvic floor disorders and multiple sclerosis: are patients satisfied with their care?","volume":"16","author":"Mahajan","year":"2014","journal-title":"Int J MS Care"},{"key":"ref28","author":"Chung","year":"2010"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"2032","DOI":"10.1016\/j.clinph.2019.08.020","article-title":"Transcranial magnetic stimulation and bladder function: a systematic review","volume":"130","author":"Nardone","year":"2019","journal-title":"Clin Neurophysiol"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"1059","DOI":"10.1007\/s11255-021-02804-y","article-title":"The effect of pelvic floor exercise program on incontinence and sexual dysfunction in multiple sclerosis patients","volume":"53","author":"Altunan","year":"2021","journal-title":"Int Urol Nephrol"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1171","DOI":"10.1007\/s00192-016-3239-6","article-title":"Comparison of pelvic floor muscle strength in nulliparous women and those with normal vaginal delivery and cesarean section","volume":"28","author":"Afshari","year":"2017","journal-title":"Int Urogynecol J"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"624","DOI":"10.1186\/s12884-022-04952-0","article-title":"Risk factors of pelvic floor muscle strength in south Chinese women: a retrospective study","volume":"22","author":"Fang","year":"2022","journal-title":"BMC Pregnancy Childbirth"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"2193","DOI":"10.1111\/aogs.14275","article-title":"Stress and urgency urinary incontinence one year after a first birth\u2014prevalence and risk factors a prospective cohort study","volume":"100","author":"Jansson","year":"2021","journal-title":"AOGS"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1514157\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T05:10:58Z","timestamp":1736745058000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2024.1514157\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,13]]},"references-count":33,"alternative-id":["10.3389\/fneur.2024.1514157"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2024.1514157","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,13]]},"article-number":"1514157"}}