Beneficial carry-over effects of chronic at-home genital nerve stimulation on incontinence in individuals with spinal cord injury: A pragmatic trial

IF 3.9 3区 医学 Q1 REHABILITATION Annals of Physical and Rehabilitation Medicine Pub Date : 2023-12-20 DOI:10.1016/j.rehab.2023.101799
Shauh-Der Yeh , Nurida Khasanah , Kenneth J. Gustafson , Chi Sun , Mei-Lin Tsai , Bor-Shing Lin , Chun-Wei Wu , Chih-Wei Peng
{"title":"Beneficial carry-over effects of chronic at-home genital nerve stimulation on incontinence in individuals with spinal cord injury: A pragmatic trial","authors":"Shauh-Der Yeh ,&nbsp;Nurida Khasanah ,&nbsp;Kenneth J. Gustafson ,&nbsp;Chi Sun ,&nbsp;Mei-Lin Tsai ,&nbsp;Bor-Shing Lin ,&nbsp;Chun-Wei Wu ,&nbsp;Chih-Wei Peng","doi":"10.1016/j.rehab.2023.101799","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Genital nerve stimulation (GNS) is a promising, but under-researched, alternative treatment for neurogenic detrusor overactivity (NDO) in those with spinal cord injury (SCI).</p></div><div><h3>Objectives</h3><p>To investigate the urodynamic, quality-of-life (QOL) and carry-over effects of GNS when applied at home for 2 weeks by participants with incomplete SCI and NDO during activities of daily living.</p></div><div><h3>Methods</h3><p>Seven men and 1 woman participated in this 1-month protocol study. Urodynamic and QOL data were gathered during week 1 (baseline measurements), followed by 2 weeks of daily GNS at home using a portable device. GNS was applied either on-demand or thrice daily, depending on the individual's sensation. At week 4, post-stimulation tests were repeated to record any carry-over effect from the GNS. Participants maintained voiding diaries throughout the study. Assessments were carried out at the end of each protocol period in a randomized order. Clinical procedures were conducted at Taipei Medical University Hospital (Taipei, Taiwan).</p></div><div><h3>Results</h3><p>Everyone completed the study but only 7 of the 8 participants completed their voiding diary. Two weeks after GNS, average cystometric bladder capacity was increased by 30 % compared to baseline (<em>P</em> <em>&lt;</em> 0.05). A 1-week carry-over effect was demonstrated as this capacity remained, on average, 35 % greater than baseline in week 4 after GNS was stopped (<em>P</em> <em>&lt;</em> 0.05). Incontinence frequency significantly decreased by the end of week 3 (<em>P</em> <em>&lt;</em> 0.05) but no significant improvements were recorded for either detrusor pressure or bladder compliance.</p></div><div><h3>Conclusions</h3><p>Chronic at-home GNS improved cystometric bladder capacity and reduced urinary incontinence for individuals with incomplete SCI and NDO. A carry-over effect of 1 week was observed following GNS treatment. The use of portable GNS treatment that can be applied by the individual at home merits further investigation as alternative treatment for NDO in those with SCI.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 2","pages":"Article 101799"},"PeriodicalIF":3.9000,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Physical and Rehabilitation Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1877065723000702","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0

Abstract

Background

Genital nerve stimulation (GNS) is a promising, but under-researched, alternative treatment for neurogenic detrusor overactivity (NDO) in those with spinal cord injury (SCI).

Objectives

To investigate the urodynamic, quality-of-life (QOL) and carry-over effects of GNS when applied at home for 2 weeks by participants with incomplete SCI and NDO during activities of daily living.

Methods

Seven men and 1 woman participated in this 1-month protocol study. Urodynamic and QOL data were gathered during week 1 (baseline measurements), followed by 2 weeks of daily GNS at home using a portable device. GNS was applied either on-demand or thrice daily, depending on the individual's sensation. At week 4, post-stimulation tests were repeated to record any carry-over effect from the GNS. Participants maintained voiding diaries throughout the study. Assessments were carried out at the end of each protocol period in a randomized order. Clinical procedures were conducted at Taipei Medical University Hospital (Taipei, Taiwan).

Results

Everyone completed the study but only 7 of the 8 participants completed their voiding diary. Two weeks after GNS, average cystometric bladder capacity was increased by 30 % compared to baseline (P < 0.05). A 1-week carry-over effect was demonstrated as this capacity remained, on average, 35 % greater than baseline in week 4 after GNS was stopped (P < 0.05). Incontinence frequency significantly decreased by the end of week 3 (P < 0.05) but no significant improvements were recorded for either detrusor pressure or bladder compliance.

Conclusions

Chronic at-home GNS improved cystometric bladder capacity and reduced urinary incontinence for individuals with incomplete SCI and NDO. A carry-over effect of 1 week was observed following GNS treatment. The use of portable GNS treatment that can be applied by the individual at home merits further investigation as alternative treatment for NDO in those with SCI.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
慢性居家生殖器神经刺激对脊髓损伤患者尿失禁的益处:一项实用性试验。
背景:生殖器神经刺激(GNS)是治疗脊髓损伤(SCI)患者神经源性逼尿肌过度活动(NDO)的一种前景广阔但研究不足的替代疗法:目的:调查不完全脊髓损伤和 NDO 患者在家中进行为期两周的日常生活活动时使用 GNS 的尿动力学、生活质量(QOL)和延续效应:七名男性和一名女性参加了这项为期 1 个月的方案研究。在第 1 周(基线测量)收集尿动力学和 QOL 数据,然后使用便携式设备在家中进行为期 2 周的每日 GNS。GNS 根据个人的感觉按需使用或每天使用三次。第 4 周时,重复进行刺激后测试,以记录 GNS 带来的任何影响。在整个研究过程中,参与者都会记录排尿日记。在每个方案期结束时,按照随机顺序进行评估。临床程序在台北医学大学附设医院(台湾台北)进行:所有人都完成了研究,但 8 名参与者中只有 7 人完成了排尿日记。GNS 使用两周后,膀胱平均容量比基线增加了 30%(P 结论:GNS 使用两周后,膀胱平均容量比基线增加了 30%:慢性居家 GNS 可改善不完全 SCI 和 NDO 患者的膀胱容量,减少尿失禁。在接受 GNS 治疗后,观察到 1 周的延续效应。可在家中使用的便携式 GNS 治疗方法值得进一步研究,可作为治疗 SCI 患者 NDO 的替代疗法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
7.80
自引率
4.30%
发文量
136
审稿时长
34 days
期刊介绍: Annals of Physical and Rehabilitation Medicine covers all areas of Rehabilitation and Physical Medicine; such as: methods of evaluation of motor, sensory, cognitive and visceral impairments; acute and chronic musculoskeletal disorders and pain; disabilities in adult and children ; processes of rehabilitation in orthopaedic, rhumatological, neurological, cardiovascular, pulmonary and urological diseases.
期刊最新文献
Return to sport after anterior cruciate ligament reconstruction - prognostic factors and prognostic models: A systematic review. “From pain to neglect behavior of peripheral origin” Diffusion tensor imaging reveals Papez circuit lesions in severe traumatic brain injury with memory disorder. Simulated breathing in virtual reality does not affect perceived effort during the physical rehabilitation of people with long COVID Intensive interdisciplinary specialized rehabilitation or regular physiotherapy for multiple sclerosis? A randomised controlled trial with economic evaluation
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1