Neuromodulation by surface electrical stimulation of peripheral nerves for reduction of detrusor overactivity in patients with spinal cord injury: A pilot study
Neuromodulation by surface electrical stimulation of peripheral nerves for reduction of detrusor overactivity in patients with spinal cord injury: A pilot study
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通过周围神经表面电刺激进行神经调节以减少脊髓损伤患者逼尿肌过度活动：一项初步研究
DOI：
10.1179/2045772313y.0000000175
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
S. Devasahayam
中科院分区：
文献类型：
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作者：
R. Ojha;Jacob George;B. Chandy;G. Tharion;S. Devasahayam
摘要目的探讨表面电刺激胫后神经（PTN）或阴茎背神经（DPN）对脊髓损伤（SCI）患者逼尿肌过度活动的影响。设计：本研究招募了有尿急/漏尿症状，膀胱测压（CMG）证实逼尿肌过度活动的SCI患者。PTN组包括10名胫神经可观察到F波的人。5例F波缺如但球海绵体肌反射保留者被纳入DPN组。以20 Hz，10-40 mA的频率给予刺激，每次20 min/天，连续14天。在第1天和第15天使用CMG记录逼尿肌过度活动。康复研究所，物理医学和康复系，基督教医学院和医院，韦洛雷，田纳西州，印度。参与者SCI患者。干预外周神经表面刺激减少逼尿肌过度活动。结果测量使用排尿日记数据进行定性分析，并使用CMG数据进行定量分析，比较干预前后。结果PTN和DPN的排尿图P值分别为0.021和0.062。从CMG数据获得的P值在两组中均不显著。在1例受试者中，治疗延长至4周，观察到排尿日记进一步改善。结论：在这项15例患者的初步研究中，排尿图数据显示PTN刺激后有统计学显著改善，DPN刺激后有改善趋势。然而，CMG数据在该样本人群中不具有统计学显著性。进一步研究更大，适当的把握度样本量将有助于证明症状与CMG数据的关联。试验注册CTRI编号; CTRI/2012/12/003234; CMCH批准号：CMC/IRB/6735/2008/12/18。
Abstract Objectives To demonstrate reduction in detrusor overactivity using surface electrical stimulation of posterior tibial nerve (PTN) or dorsal penile nerve (DPN) in patients with spinal cord injury (SCI). Design Patients with SCI with symptoms of urinary urgency/leaks, with cystometrogram (CMG) proven detrusor overactivity were recruited in this study. Ten persons with observable F-wave from tibial nerve were included in the PTN group. Five persons who had F-wave absent but preserved bulbocavernosus reflex were included in the DPN group. Stimulation was given at 20 Hz, 10–40 mA for 20 minutes/session/day for 14 consecutive days. Detrusor overactivity was recorded using CMG on days 1 and 15. Settings Rehabilitation Institute, Department of Physical Medicine and Rehabilitation, Christian Medical College and Hospital, Vellore, TN, India. Participants Patients with SCI. Interventions Surface stimulation of peripheral nerves for reduction of detrusor overactivity. Outcome measures Qualitative analysis using voiding diary data and quantitative analysis using CMG data comparing pre- and post-intervention. Results P value obtained from voiding chart was 0.021 for PTN and 0.062 for DPN. P value obtained from CMG data was not significant in both groups. In one subject, treatment was extended to 4 weeks and further improvement in voiding diary was seen. Conclusions In this pilot study of 15 patients, voiding chart data showed statistically significant improvement following PTN stimulation and trend of improvement following DPN stimulation. However, the CMG data were not statistically significant in this sample population. Further studies with larger, appropriately powered sample size would be helpful to demonstrate the associations of symptoms with CMG data. Trial registration CTRI no.; CTRI/2012/12/003234; CMCH Approval no.: CMC/IRB/6735/2008/12/18.