External Pelvic Floor Biofeedback for Children With Spinal Cord Injury: A Case Series.

IMPORTANCE

Neurogenic bladder can negatively affect quality of life for children with incomplete spinal cord injury. Occupational therapy practitioners are uniquely able to provide individualized care to address this, which may include external pelvic floor biofeedback.

OBJECTIVE

To describe the implementation of external pelvic floor biofeedback for bladder management within the context of toileting for children with neurogenic bladder dysfunction following incomplete spinal cord injury.

DESIGN

Retrospective case series.

SETTING

Inpatient rehabilitation unit within a pediatric hospital.

PARTICIPANTS

Three children with incomplete spinal cord injury were enrolled.

INTERVENTION: External pelvic floor biofeedback.

OUTCOMES AND MEASURES: The study used the Functional Independence Measure for Children (WeeFIM®), Activity Measure for Post-Acute Care (AM-PAC) Daily Activities Short Form, Pediatric Spinal Cord Injury Activity Measures (PEDI-SCI AM) Short Forms, and voiding characteristics.

RESULTS

No adverse events occurred. Following biofeedback, all children improved their AM-PAC toileting scores, and PEDI-SCI AM scores improved for 2 of 3 children, whereas daily catheterization requirements decreased for all children. The WeeFIM did not detect changes in bladder management for 2 of 3 children.

CONCLUSIONS AND RELEVANCE: This case report described how occupational therapy practitioners used external pelvic floor biofeedback as an adjunct conservative treatment strategy when providing care for pediatric children with recent incomplete spinal cord injury. Plain-Language Summary: Neurogenic bladder dysfunction following incomplete spinal cord injury can negatively affect a child's quality of life and social participation. Occupational therapy practitioners are uniquely able to address bladder management within the context of toileting for children with acquired incomplete spinal cord injury. A multimodal approach, which includes biofeedback, may improve the child's level of independence with toileting.