Grant: DRA : Canada Graduate Research Scholarship - Doctoral Program (CGRS D)

Bladder problems affect over 80% of people living with paralysis due to spinal cord injury (SCI), but current bladder management options frequently prove unsuccessful, necessitating the search for alternative strategies. The pelvic floor muscles (PFM) form the base of our "core" and can be a potential therapeutic target given their important role in bladder control. PFM training programs, which involve exercises designed to strengthen and improve the control of this muscle group, are the first-line treatment for many people experiencing bladder problems (e.g., urine leakage) in cases like recovery after childbirth. There is some evidence that PFM training can be beneficial for bladder outcomes in people with SCI, but we do not fully understand how and why it works. This study is designed to investigate if the training works by strengthening the connections between the brain and the PFM in people with SCI. To address this, we will use different laboratory measurements to (1) examine the strength of the neural inputs from the brain to the PFM; (2) quantify the amount of electrical activity generated by the PFM and (3) the relationship between nerve cell activities in the brain and spinal cord during voluntary PFM activation. We plan to recruit 20 adults with SCI to participate in a 12-week PFM training program. We will perform these measures twice at the beginning to check how well they agree with each other on two separate days (reliability), and once again after the training to show how well the participants improve their PFM control. By establishing measurement tools that characterize the neural control of the PFM, findings from this study will facilitate future research on the benefits of exercises targeting the PFM as an effective and non-invasive option for bladder management after SCI.