To study the short-term effect of bilateral transcutaneous tibial nerve stimulation (TTNS) on urodynamic study (UDM) parameters in spinal cord injury (SCI) patients with neurogenic detrusor overactivity (NDO).
Single-blinded sham-controlled study.
Seventeen SCI patients with NDO were recruited. Fifteen patients (mean age 40±18 years) completed the study. Most of them were chronic incomplete SCI.
UDM was performed three times. The first UDM was performed after taking anticholinergics for one hour to assess the effects of medication. After stopping anticholinergics for a 5 half-lives, the second UDM was performed immediately after a 20-min sham TTNS (switch on for 30 sec at the beginning, switch off for 20 min, and switch on for 30 sec before stopping). The third UDM was performed immediately after a 20-min bilateral TTNS.
Reflex volume (ml); cystometric capacity (ml); maximum pressure detrusor (mmH2O); and bladder compliance (ml/mmH2O).
UDM tracings were interpreted by 2 blinded assessors. This study used per-protocol analysis and repeated measures ANOVA with Bonferroni post-hoc analysis. When compared with sham stimulation, bilateral TTNS and anticholinergics produced greater increases in reflex volume (136.1±99.88, 212.2±112.82, 226.3±111.52 ml, P<.001), cystometric capacity (218.3±137.66, 319.1±143.74, 350.7±163.43 ml, P<.001) and compliance (5.8±6.81, 7.9±6.74, 9.7±8.12 ml/cmH2O, P=.02). No significant differences in reflex volume, cystometric capacity or compliance were found between bilateral TTNS and anticholinergics (P>.05). The maximum pressure detrusor was not significantly different between groups (P>.05).
Bilateral TTNS may be an effective short-term intervention to improve UDM parameters in SCI with NDO. Further study is necessary to determine the long-term effects and benefits of combined bilateral TTNS with anticholinergics.
Archives of physical medicine and rehabilitation. 2020 Nov 24 [Epub ahead of print]
Kornkamon Kamboonlert, Sirikwan Panyasriwanit, Natthiya Tantisiriwat, Wasuwat Kitisomprayoonkul
Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University., Thai Red Cross Rehabilitation Center., Division of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital, Thailand., Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University. Electronic address: .