Argyrios Stampas1,2, Radha Korupolu1,2, Liang Zhu3, Christopher P Smith4, Kenneth Gustafson5,6. 1. Department of PM&R, UTHealth at Houston, Houston, TX, USA. 2. TIRR Memorial Hermann, Houston, TX, USA. 3. Biostatistics and Epidemiology Research Design Core, UTHealth at Houston, Houston, TX, USA. 4. Department of Urology, Baylor College of Medicine, Houston, TX, USA. 5. Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH, USA. 6. Case Western Reserve University, Department of Urology, Cleveland, OH, USA.
Abstract
OBJECTIVES: We investigated whether transcutaneous tibial nerve stimulation (TTNS) in acute spinal cord injury was safe and feasible, and could achieve neuromodulation and improve cystometrogram parameters during acute inpatient rehabilitation. MATERIALS AND METHODS: Participants were consecutive acute traumatic spinal cord injury patients admitted for acute inpatient rehabilitation, randomized to a 2-week trial of TTNS v sham stimulation. Primary outcomes were safety and feasibility of TTNS and secondary outcomes were bladder measures based on pre- and post-TTNS cystometrogram by group and within groups, including bladder capacity, detrusor hyperreflexia, pressures, and detrusor-sphincter dyssynergia, as well as filling sensations and desire to void. The principle investigator and subjects were blinded to treatment allocation. RESULTS: A total of 19 subjects consented to the study and completed the stimulation protocol. Morbidity was similar between groups and compliance was 100% to the TTNS protocol. Based on a lack of rehabilitation interruptions and comments from staff, TTNS was feasible. Post-cystometrogram parameters were significant for lower volumes until sensation in the control group and prolonged volumes until sensation in the TTNS group. The control group had significant changes of increased detrusor-sphincter dyssynergia and decreased bladder capacity. This was not significantly changed in the TTNS group. CONCLUSIONS: TTNS is a safe and feasible modality that can be performed during inpatient rehabilitation of acute traumatic spinal cord injury. Bladder capacity and episodes of detrusor-sphincter dyssynergia significantly worsened in the control group and did not significantly change in the TTNS group, suggesting that TTNS can alter the course of neurogenic bladder via neuromodulation.
OBJECTIVES: We investigated whether transcutaneous tibial nerve stimulation (TTNS) in acute spinal cord injury was safe and feasible, and could achieve neuromodulation and improve cystometrogram parameters during acute inpatient rehabilitation. MATERIALS AND METHODS: Participants were consecutive acute traumatic spinal cord injury patients admitted for acute inpatient rehabilitation, randomized to a 2-week trial of TTNS v sham stimulation. Primary outcomes were safety and feasibility of TTNS and secondary outcomes were bladder measures based on pre- and post-TTNS cystometrogram by group and within groups, including bladder capacity, detrusor hyperreflexia, pressures, and detrusor-sphincter dyssynergia, as well as filling sensations and desire to void. The principle investigator and subjects were blinded to treatment allocation. RESULTS: A total of 19 subjects consented to the study and completed the stimulation protocol. Morbidity was similar between groups and compliance was 100% to the TTNS protocol. Based on a lack of rehabilitation interruptions and comments from staff, TTNS was feasible. Post-cystometrogram parameters were significant for lower volumes until sensation in the control group and prolonged volumes until sensation in the TTNS group. The control group had significant changes of increased detrusor-sphincter dyssynergia and decreased bladder capacity. This was not significantly changed in the TTNS group. CONCLUSIONS: TTNS is a safe and feasible modality that can be performed during inpatient rehabilitation of acute traumatic spinal cord injury. Bladder capacity and episodes of detrusor-sphincter dyssynergia significantly worsened in the control group and did not significantly change in the TTNS group, suggesting that TTNS can alter the course of neurogenic bladder via neuromodulation.
Authors: Andrea M Sartori; Souzan Salemi; Anna-Sophie Hofer; Valentin Baumgartner; Daniel Eberli; Martina D Liechti; Martin E Schwab; Thomas M Kessler Journal: Neurotrauma Rep Date: 2022-02-14
Authors: Robert F Hoey; Daniel Medina-Aguiñaga; Fahmi Khalifa; Beatrice Ugiliweneza; Dengzhi Wang; Sharon Zdunowski; Jason Fell; Ahmed Naglah; Ayman S El-Baz; April N Herrity; Susan J Harkema; Charles H Hubscher Journal: Sci Rep Date: 2022-02-08 Impact factor: 4.996
Authors: Veronika Birkhäuser; Martina D Liechti; Collene E Anderson; Lucas M Bachmann; Sarah Baumann; Michael Baumberger; Lori A Birder; Sander M Botter; Silvan Büeler; Célia D Cruz; Gergely David; Patrick Freund; Susanne Friedl; Oliver Gross; Margret Hund-Georgiadis; Knut Husmann; Xavier Jordan; Miriam Koschorke; Lorenz Leitner; Eugenia Luca; Ulrich Mehnert; Sandra Möhr; Freschta Mohammadzada; Katia Monastyrskaya; Nikolai Pfender; Daniel Pohl; Helen Sadri; Andrea M Sartori; Martin Schubert; Kai Sprengel; Stephanie A Stalder; Jivko Stoyanov; Cornelia Stress; Aurora Tatu; Cécile Tawadros; Stéphanie van der Lely; Jens Wöllner; Veronika Zubler; Armin Curt; Jürgen Pannek; Martin W G Brinkhof; Thomas M Kessler Journal: BMJ Open Date: 2020-08-13 Impact factor: 2.692