Effect of Conventional Physiotherapy on Bladder Control and Quality of Life in Patients With Non-traumatic Postoperative Spinal Cord Injury.

Introduction Non-traumatic spinal cord injury (NTSCI) arising from postoperative complications of degenerative spinal disorders represents a clinically significant cause of neurogenic bladder dysfunction and diminished quality of life. Neurogenic lower urinary tract dysfunction is one of the most distressing sequelae of spinal cord involvement, leading to urinary incontinence, incomplete bladder emptying, and recurrent urinary tract infections. Conventional physiotherapy, incorporating pelvic floor muscle training (PFMT), bladder training, core strengthening, and functional mobility exercises, offers a structured, non-pharmacological rehabilitation strategy. However, evidence specifically addressing its role in bladder control and quality of life in this population remains limited. This study investigated the effect of a four-week conventional physiotherapy program on bladder control and quality of life in patients with non-traumatic postoperative spinal cord injury (SCI). Methods A single-group pre-post interventional study was conducted at Krishna College of Physiotherapy, Krishna Vishwa Vidyapeeth, Karad. Twenty participants (mean age: 52.40 + 9.87 years; 12 males, 8 females; American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades C and D) diagnosed with non-traumatic postoperative SCI (predominantly lumbar spondylosis with laminectomy/discectomy) were enrolled. Participants underwent a structured four-week conventional physiotherapy program, five sessions per week, each lasting 45-60 minutes. Bladder control was assessed using the validated Neurogenic Bladder Symptom Score (NBSS) and bladder diary parameters; quality of life was evaluated using the validated World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire. Urodynamic study (UDS), uroflowmetry, and upper urinary tract imaging were not performed in this study. Data were collected at baseline and at four weeks post-intervention and analyzed using a paired t-test. Results Following four weeks of conventional physiotherapy, statistically significant improvements were observed in both bladder control and quality of life. The mean NBSS score improved significantly from 35.80 ± 4.62 at baseline to 22.45 ± 3.87 post-intervention (p < 0.001). The mean WHOQOL-BREF total score improved from 52.30 ± 6.14 to 68.75 ± 5.43 (p < 0.001), indicating meaningful gains in the overall quality of life. These findings demonstrated significant improvements in bladder symptoms and quality of life following the intervention; however, causal conclusions regarding treatment effectiveness cannot be established due to the absence of a control group. Conclusion A structured four-week conventional physiotherapy program produced significant improvements in neurogenic bladder control and quality of life in patients with non-traumatic postoperative SCI. These findings suggest that conventional physiotherapy may be a beneficial rehabilitation strategy for improving bladder control and quality of life in patients with non-traumatic postoperative SCI. However, controlled studies with larger sample sizes and longer follow-up periods are required to confirm these preliminary findings.