Effect of Pelvic Floor Neurodynamics on Bladder Control and Quality of Life in Non-traumatic Post-operative Spinal Cord Injury

Introduction Spinal cord injury (SCI) results in profound neurological deficits, including bladder dysfunction that significantly impairs quality of life. Non-traumatic SCI, arising from spinal stenosis, tumours, or disc prolapse, accounts for a growing proportion of SCI cases globally. Neurogenic bladder dysfunction, manifesting as urgency, incontinence, or retention, remains one of the most debilitating sequelae. Pelvic floor neurodynamics (PFN), integrating neural mobilisation techniques with targeted pelvic floor rehabilitation, represents a novel therapeutic approach. However, its efficacy in the post-operative non-traumatic SCI population has not been formally evaluated. Method A randomised controlled trial was conducted at Krishna College of Physiotherapy in Karad, Maharashtra, India. Twenty-four participants (aged 30-60 years) with non-traumatic SCI and neurogenic bladder dysfunction were randomly allocated into two groups (n = 12 each). Group A (experimental) received PFN combined with conventional physiotherapy; group B (control) received conventional physiotherapy alone. Both protocols were delivered over two weeks. Outcome measures were the International Consultation on Incontinence Questionnaire (ICIQ) and the Spinal Cord Independence Measure (SCIM), assessed pre- and post-intervention using paired and independent samples t-tests. Result Group A showed a mean ICIQ reduction of 7.50 points (16.75 to 9.25; p < 0.001) and a mean SCIM gain of 21.08 points (46.25 to 67.33; p < 0.001). Group B showed a mean ICIQ reduction of 3.42 points (p < 0.01) and a SCIM gain of 10.25 points (p < 0.001). Between-group comparisons confirmed significantly superior outcomes in group A on both ICIQ (p < 0.01) and SCIM (p < 0.05), with improvements more than double those in the control group. Conclusion The addition of PFN to conventional physiotherapy significantly enhances bladder control and functional independence in non-traumatic post-operative SCI. These findings support the integration of neurodynamic techniques into standard SCI rehabilitation protocols.