Grant: Project Grant

Up to 80% of people with spinal cord injury (SCI) are unable to control their bladder. Lack of bladder control (urinary incontinence) and changes in bladder function following SCI have dramatic impacts on quality of life and can lead to serious side effects, even death. Regaining bladder control is a top priority for those with SCI. There are treatments (mainly medications) for bladder problems for people with SCI, but these are associated with side effects and high failure rates. Some reports estimate that up to 70% of people taking medications for bladder problems stop taking them within the first year due to their negative side effects. New strategies for managing bladder problems are therefore necessary. In this research project, we will explore how different types of exercises targeting the 'core' may help improve bladder function in people with SCI. This research could ultimately benefit most people with SCI who suffer from bladder problems. We are building upon well-established physiotherapy strategies that have been developed for other populations that aim to strengthen the muscles of the abdomen and the pelvic floor (the muscles used to hold in or stop the flow of urine). People with SCI are generally assumed to have trouble activating their core muscles, which might be why exercise-based therapies have not been tried before to treat them. However, we have found that many individuals with SCI are able to recruit the muscles of the core and are able to activate their pelvic floor muscles indirectly, even if they are considered to be completely paralyzed. We have also found that when they walk with the help of a robotic exoskeleton, their abdominal and pelvic floor muscles are active. We already know that exercise is good for bone, muscle, and heart health in people with SCI; we hope to show that exercise can also help improve bladder health.