Wearables for the Bladder: Self-management tools to increase participation in daily life for people with multiple sclerosis - Wearables for the Bladder: Self-management tools to increase participation in daily life for people with multiple sclerosis Bladder dysfunction (BD) affects over 85% of people with multiple sclerosis (PwMS), significantly limiting their physical activity, social participation, and quality of life. BD often leads to urinary urgency, leakage, disrupted sleep, and increased risk of falls, creating barriers to independence and full engagement in daily life. Despite BD’s widespread impact, PwMS have few non-invasive, personalized treatment or management options and seek effective solutions. This study aims to evaluate the effectiveness of home bladder wearables, paired with education and self management strategies, to address these unmet needs and enhance the lives of PwMS. Building on preliminary data demonstrating the feasibility and effectiveness of bladder wearables in real-world settings, we propose a three year study grounded in the International Classification of Functioning (ICF) framework. Our preliminary findings indicate that bladder wearables provide valid, feasible measures of BD and support self-management goals such as improving dosage of bladder rehabilitation, timing activities outside the home, and managing urgency through visual feedback. By increasing self efficacy and promoting sustainable self-management of BD, we aim to improve bladder function, activity levels, and social participation while identifying and addressing key environmental factors affecting sustainability of device use at home. To accomplish this, we have three aims. 1) Evaluate the effectiveness of home bladder wearables on bladder function (e.g., leakage episodes, frequency, urgency) over 6 months. Participants will use devices including a wearable bladder ultrasound (DFree®), a gaming Kegel exerciser (Perifit, for women), and a Kegel exerciser (for men). Devices will be paired with training, troubleshooting resources, and optional support via scheduled check-ins and weekly office hours. We hypothesize that wearables will improve BD by increasing the intensity, frequency, and duration of self management interventions. 2) Assess the impact of home bladder wearables on activity and participation outcomes, including physical activity, sleep, and social participation. We will collect data using activity monitors, validated patient-reported outcomes (PROs), and Global Positioning System (GPS) data (enabled on the physical activity monitor) and a PRO to measure mobility range and social withdrawal. We hypothesize that using home bladder wearables will lead to sustained improvements in physical activity, sleep, and social participation by reducing BD related barriers. 3) Explore environmental factors influencing the long-term use of bladder wearables. We will identify barriers and facilitators PwMS report during study interviews and develop a research plan for a larger, multicenter intervention study. Stakeholders, including PwMS and experts, will provide input throughout the study to ensure its design, implementation, and dissemination are patient-centered and actionable. This study addresses an urgent need for non-invasive, effective BD solutions for PwMS. By advancing the use of bladder wearables for self-management, this research has the potential to sustainably improve independence, reduce activity limitations, and enhance social participation for PwMS. The findings will provide critical insights for scaling up this approach and informing future research and clinical practices.
