Exploring the Feasibility and Benefits of Implementing Pelvic Floor Muscle Training During Inpatient Rehabilitation for People With Spinal Cord Injury

The goal of this clinical study is to determine the feasibility and explore the potential benefits of pelvic floor muscle training during inpatient SCI rehabilitation on urinary, bowel, and sexual function and quality of life in people with SCI. The main questions it aims to answer are:

1. What is the feasibility of recruiting inpatients from SCI rehabilitation to a pelvic floor muscle training program?
2. What is the feasibility and acceptance of the implementation of a pelvic floor muscle training program in SCI inpatient rehabilitation?
3. What are the potential effects of a pelvic floor muscle training program implemented in SCI inpatient rehabilitation on bladder, bowel, and sexual function and quality of life?

Participants will be asked to complete a series of assessments (questionnaires, physical assessments) before and after a 6-week intervention of pelvic floor physical therapy.

Study Overview

• Status: Recruiting
• Conditions: Spinal Cord Injuries (SCI)
• Intervention / Treatment: Behavioral: Pelvic Floor Muscle Physiotherapy

• Study Type: Interventional
• Enrollment (Estimated): 50
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Jiho Song; Phone Number: 604-675-8815; Email: lamlab@icord.org

Study Locations

• Canada
  • British Columbia
    • Vancouver, British Columbia, Canada, V5Z 2G9
      • Recruiting
      • GF Strong Rehabilitation Centre
      • Contact: Amrit Dhaliwal; Phone Number: 604-675-8815; Email: amrit.dhaliwal@vch.ca

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

1. Are at least 19 years of age.
2. Have a traumatic or non-traumatic SCI
3. Are able to perform a voluntary anal contraction
4. Present with bladder or urinary tract dysfunction from SCI
5. Are a current inpatient at GF Strong Rehabilitation Center and are expected to remain as an inpatient for at least 6 weeks after the time of consent.
6. Are able to speak and understand English.

Exclusion Criteria:

1. Present with symptoms of lower motor neuron injury to the sacral segments (e.g. negative anal and bulbocavernosus reflexes)
2. Present with any other condition besides SCI that impacts the pelvic floor muscles or other pelvic structures
3. Are planning to receive intra-detrusor Botox injections in the next 3 months
4. Have a brain injury or other condition that interferes with their ability to follow instructions
5. Are using a ventilator
6. Have severe and unmanaged spasticity (involuntary muscle tightness or spasms) or contractures (prolonged muscle/joint stiffness)
7. Are unable to tolerate transfers to or lie on a physical therapy table
8. Experience severe pain that interferes with their ability to participate in pelvic floor muscle training

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pelvic Floor Muscle Physical Therapy; Pelvic floor muscle physical therapy 5/week for 6 weeks.	Behavioral: Pelvic Floor Muscle Physiotherapy; Pelvic floor muscle physiotherapy 5x/week for 6-weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Feasibility - Compliance	Compliance will be tracked by the number of participants who underwent the intervention, as well as their adherence to the prescribed exercise program (attendance to supervised sessions and diaries), with reasons for missed sessions or drop-outs noted.	Through study completion, an average of 8 months
Feasibility - Recruitment Rate	Recruitment Rate will be evaluated by the number of participants approached, screened for eligibility, and invited to enroll in the study, relative to the number of overall inpatients admitted to the GF Strong Rehabilitation Center SCI unit. We will document the number of participants who enrolled, declined enrollment, or did not respond to our invitation to enroll, as well as the reasons for not enrolling when available.	Through study completion, an average of 8 months
Feasibility - Acceptability (Perceived Acceptability Questionnaire)	Acceptability of the intervention will be assessed using a study-specific questionnaire, the Perceived Acceptability Questionnaire, developed for this study. The questionnaire aims to capture participants' enjoyment of the PFMT program and their perceptions of its benefits for urinary, bowel, and sexual health. Each item is rated on a 7-point Likert scale from 1 (strongly disagree) to 7 (strongly agree), with higher scores reflecting greater perceived acceptability and benefit.	Through study completion, an average of 8 months

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
International Index of Erectile Function (IIEF) Questionnaire	Male participants will be asked to complete the IIEF questionnaire which askes 15 questions to clinically assess sexual health in 5 domains, each with their own score range: erectile function (0-30), orgasmic function (0-10), sexual desire (0-10), intercourse satisfaction (0-15), overall satisfaction (0-10). A lower score represents greater dysfunction or dissatisfaction in any of the subdomains.	Through study completion, an average of 8 months
Incontinence Quality of Life Questionnaire (I-QoL)	Participants will be asked to respond to 22 questions about how urinary incontinence impacts their quality of life using a 5-point scale with values ranging from 1 (extremely) to 5 (not at all). The questionnaire probes three subdomains of how incontinence may affect quality of life: avoidance and limiting behaviour, psychosocial impact, and social embarrassment. The total score on this questionnaire ranges from 0 to 100, with higher scores indicating a higher quality of life.	Through study completion, an average of 8 months
Neurogenic Bladder Symptoms Score (NBSS)	Participants will be asked to respond to 24 questions regarding the severity of their bladder symptoms secondary to neurological injury. Questions cover three subdomains: incontinence, storage and voiding, and consequences. The total score on this questionnaire ranges from 0 to 74, with lower scores indicating less severe symptoms.	Through study completion, an average of 8 months
Timed Bowel Routine	Participants will be asked how long their bowel movements take, and what (if any) aids they used to complete the bowel movement (e.g. suppository, laxatives, digital stimulation/evacuation, help of another person, etc.).	Through study completion, an average of 8 months
Neurogenic Bowel Dysfunction Score (NBDS)	Participants will be asked to complete the NBDS questionnaire, which asks 11 questions to clinically assess the severity of their bowel dysfunction symptoms. The total score on this questionnaire ranges from 0 to 47, with higher scores indicating greater bowel dysfunction symptoms.	Through study completion, an average of 8 months
Female Sexual Function Index (FSFI) Questionnaire	Female participants will be asked to complete the FSFI questionnaire, which asks 19 questions to clinically assess sexual health in 6 domains: desire, arousal, lubrication, orgasm, satisfaction, and pain. The total score on this questionnaire ranges from 0 to 36, with lower scores indicating greater dysfunction, dissatisfaction, or pain.	Through study completion, an average of 8 months
Sexual Quality of Life Questionnaire - Male/Female (SQoL)	Participants will complete the sex-specific version of this questionnaire corresponding to their sex. The male version includes 11 items and the female version includes 18 items, with respondents rating their level of agreement or disagreement with each statement. Total scores range from 11 to 66 for males and 18 to 108 for females. In both versions, lower scores reflect poorer sexual quality of life.	Through study completion, an average of 8 months
S4/5 Questionnaire	Participants will be asked to complete a brief questionnaire that asks about their sensation at the S4/5 dermatomes (near and just inside the anal canal), and their ability to perform voluntary anal contractions. This questionnaire is not scored and will be reported descriptively.	Through study completion, an average of 8 months
Pelvic Floor Electromyography	PFM function (i.e., endurance and motor control) will be assessed using surface electromyography (EMG). Two pairs of disposable EMG electrodes will be placed perianally to record bilaterally from the pelvic floor. Additional surface EMG sensors will be placed bilaterally over other muscles of the core (e.g. abdominals, glutes). Participants will be instructed to attempt a maximal, isolated PFM contraction (Kegel). The research team will provide standardized, sex-specific instructions for performing this movement. If the participant can perform an isolated PFM contraction, we will assess their motor control by asking them to perform a series of rapid contract-relax cycles. We will also assess endurance by asking them to try to hold a PFM contraction for up to 1 minute. All maneuvers may be recorded up to 3 times.	From enrollment to the end of treatment at 6-weeks, or discharge from inpatient care
Ultrasound Assessment	The PFM function will be assessed through transperineal ultrasound. An ultrasound probe will be placed on the perineum to visualize the pelvic floor and other relevant pelvic structures (e.g. bladder, urethra, vaginal canal, sphincters, pelvic bones). Ultrasound images and recordings will be obtained while the participant is at rest and during PFM contractions.	From enrollment to the end of treatment at 6-weeks, or discharge from inpatient care

Collaborators and Investigators

• Sponsor: University of British Columbia
• Collaborators: Canadian Institutes of Health Research (CIHR)

Study record dates

Study Major Dates

• Study Start (Estimated): April 1, 2026
• Primary Completion (Estimated): September 30, 2027
• Study Completion (Estimated): March 31, 2028

Study Registration Dates

• First Submitted: April 2, 2026
• First Submitted That Met QC Criteria: April 2, 2026
• First Posted (Actual): April 9, 2026

Study Record Updates

• Last Update Posted (Actual): April 15, 2026
• Last Update Submitted That Met QC Criteria: April 11, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Physical Therapy; Physiotherapy; Spinal Cord Injury; Pelvic Floor Muscles
• Additional Relevant MeSH Terms: Central Nervous System Diseases; Nervous System Diseases; Wounds and Injuries; Trauma, Nervous System; Spinal Cord Diseases; Spinal Cord Injuries
• Other Study ID Numbers: H26-00445

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No