The Relationship Between Bladder and Bowel Function With Hip and Trunk Strength and Walking Outcomes in People With Multiple Sclerosis

Purpose: This study examined the relationship between bladder/bowel dysfunctions, proximal muscle strength, and clinical walking outcomes in individuals with multiple sclerosis (MS). Methods: This analysis included 94 people with MS with mild-to-moderate disability (Expanded Disability Status Scale [EDSS] ≤ 5.5). The EDSS Bladder and Bowel Functional Systems (EDSS-BBFS) score measured bladder/bowel function. Hip abduction and lateral trunk muscle strength were measured through handheld dynamometry, and a curl-up test measured trunk flexion. Walking was evaluated using the 6-Minute Walk Test (6MWT), Timed 25-Foot Walk (T25FW), and the 12-Item MS Walking Scale (MSWS-12). Associations between EDSS-BBFS scores, muscle strength, and walking outcomes were analyzed using Spearman’s rank correlations, while differences between EDSS-BBFS groups were assessed using analysis of variance. Results: The sample was 79% female, 48.21 ± 11.28 years old, with an EDSS score of 3.5 ± 1.0. The EDSS-BBFS score was normal for 25.5%, mild for 47.9%, and moderate-severe for 26.6% of the sample. There were significant ( P ≤ .05), fair-to-moderate correlations between EDSS-BBFS scores and hip abduction (ρ = −0.31), lateral trunk (ρ = −0.37), and trunk flexion (ρ = −0.31); and T25FW (ρ = −0.29), 6MWT (ρ = −0.35), and MSWS-12 (ρ = 0.32). Muscle strength and MSWS-12 values were significantly worse in those with moderate-severe EDSS-BBFS scores compared to those with normal and mild scores ( P ≤ .05). Timed 25-Foot Walk and 6MWT were significantly worse in those with moderate-severe EDSS-BBFS scores compared to those with mild scores ( P ≤ .05). Discussion: Clinicians may consider screening for bladder/bowel dysfunction in people with MS who have proximal weakness and walking impairments. Future research is needed to investigate how these findings might influence potential clinical interventions.