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External Pelvic Floor Biofeedback for Children With Spinal Cord Injury: A Case Series
Meredith Ten Brink1, Laura Rucki2, Erin Gates3
1Meredith ten Brink, OT, OTD, OTR/L, BCP, CBIS, CPST, CTRS, is Occupational Therapy Clinical Leader, Department of Clinical Therapies, Nationwide Children's Hospital, Columbus, OH; meredith.tenbrink@nationwidechildrens.org.
Insights
Occupational therapy using external pelvic floor biofeedback improved toileting independence and decreased catheterization in children with neurogenic bladder due to spinal cord injury. This conservative approach enhanced quality of life and social participation.
Area of Science:
- Pediatric Rehabilitation
- Neuroscience
- Urology
Background:
- Neurogenic bladder significantly impacts quality of life in children with incomplete spinal cord injury (SCI).
- Occupational therapy offers individualized interventions for bladder management in pediatric SCI.
- External pelvic floor biofeedback is a potential conservative treatment strategy.
Purpose of the Study:
- To describe the implementation of external pelvic floor biofeedback for bladder management in children with neurogenic bladder dysfunction.
- To evaluate the effectiveness of this intervention within the context of toileting for pediatric SCI patients.
Main Methods:
- Retrospective case series design.
- Inpatient rehabilitation setting within a pediatric hospital.
- Three children with incomplete SCI received external pelvic floor biofeedback as part of their occupational therapy.
Main Results:
- No adverse events were reported during the intervention.
- All participants showed improved Activity Measure for Post-Acute Care (AM-PAC) toileting scores.
- Two out of three children demonstrated improved Pediatric Spinal Cord Injury Activity Measures (PEDI-SCI AM) scores, and all experienced decreased daily catheterization needs.
Conclusions:
- External pelvic floor biofeedback can be an effective adjunct conservative treatment for pediatric neurogenic bladder post-SCI.
- Occupational therapy plays a crucial role in addressing bladder management and improving independence in toileting.
- A multimodal approach including biofeedback may enhance functional outcomes and quality of life for children with SCI.
Importance:
Neurogenic bladder can negatively affect quality of life for children with incomplete spinal cord injury. Occupational therapy practitioners are uniquely able to provide individualized care to address this, which may include external pelvic floor biofeedback.
Objective:
To describe the implementation of external pelvic floor biofeedback for bladder management within the context of toileting for children with neurogenic bladder dysfunction following incomplete spinal cord injury.
Design:
Retrospective case series.
Setting:
Inpatient rehabilitation unit within a pediatric hospital.
Participants:
Three children with incomplete spinal cord injury were enrolled.
Intervention:
External pelvic floor biofeedback.
Outcomes And Measures:
The study used the Functional Independence Measure for Children (WeeFIM®), Activity Measure for Post-Acute Care (AM-PAC) Daily Activities Short Form, Pediatric Spinal Cord Injury Activity Measures (PEDI-SCI AM) Short Forms, and voiding characteristics.
Results:
No adverse events occurred. Following biofeedback, all children improved their AM-PAC toileting scores, and PEDI-SCI AM scores improved for 2 of 3 children, whereas daily catheterization requirements decreased for all children. The WeeFIM did not detect changes in bladder management for 2 of 3 children.
Conclusions And Relevance:
This case report described how occupational therapy practitioners used external pelvic floor biofeedback as an adjunct conservative treatment strategy when providing care for pediatric children with recent incomplete spinal cord injury. Plain-Language Summary: Neurogenic bladder dysfunction following incomplete spinal cord injury can negatively affect a child's quality of life and social participation. Occupational therapy practitioners are uniquely able to address bladder management within the context of toileting for children with acquired incomplete spinal cord injury. A multimodal approach, which includes biofeedback, may improve the child's level of independence with toileting.
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