magistrsko delo
Katja Stanonik (Author), Urška Puh (Reviewer), Darja Rugelj (Mentor), Darija Šćepanović (Co-mentor)

Abstract

Uvod: Urgentna urinska inkontinenca je najbolj moteč simptom sindroma prekomerno aktivnega sečnega mehurja. Transkutana električna stimulacija tibialnega živca (TS-TŽ) je oblika periferne nevromodulacije, katere cilj je indirektna inhibicija nehotenih kontrakcij sečnega mehurja. Kljub obetajočim izidom TS-TŽ razlika med placebo električno stimulacijo in aktivno stimulacijo tibialnega živca še ni docela raziskana. Namen: Namen magistrskega dela je bil primerjati učinkovitost TS-TŽ z jakostjo električne stimulacije nad motoričnim pragom s placebo TS-TŽ na subjektivno oceno izboljšanja stanja simptomov urgentne urinske inkontinence. Metode dela: V randomiziran s placebom kontroliran preizkus je bilo vključenih 31 odraslih žensk z napotno diagnozo urgentne urinske inkontinence, ki se niso pozitivno odzvale na predhodno zdravljenje. Preiskovanke so bile skupno deležne šestkratne TS-TŽ z intenziteto nad motoričnim pragom ali šestkratne placebo TS-TŽ. Primarni izid raziskave je predstavljala subjektivna sprememba stanja simptomov urgentne urinske inkontinence, merjena z lestvico subjektivne ocene spremembe stanja. Sekundarni izid raziskave je predstavljala sprememba parametrov glede na tridnevni dnevnik uriniranja in vprašalnik Mednarodnega posveta za inkontinenco – kratka oblika. Rezultati: Protokol električne stimulacije je uspešno zaključilo 27 (87 %) preiskovank. Po končani električni stimulaciji se je stanje zmerno ali izrazito izboljšalo pri treh od 16 preiskovank v TS-TŽ skupini in pri eni od 11 preiskovank v placebo skupini. Razlika v izboljšanju stanja med obema skupinama ni bila statistično značilna (p = 0,624). Nobeni izmed oseb v TS-TŽ skupini in placebo skupini se stanje po protokolu električne stimulacije ni poslabšalo. Stanje se po TS-TŽ in placebo stimulaciji ni statistično značilno spremenilo pri nobeni izmed merjenih spremenljivk. Razprava in zaključek: Šestkratna TS-TŽ pri ženskah z urgentno urinsko inkontinenco, ki se niso pozitivno odzvale na predhodno zdravljenje, ne vodi v statistično značilno izboljšanje stanja. Eno izmed možnosti za odsotnost učinka TS-TŽ v naši raziskavi je krajše trajanje protokola električne stimulacije kot v podobnih raziskavah. Ključne omejitve izvedene raziskave predstavljajo: majhno število vključenih preiskovank, odsotnost oslepitve preiskovalk in odsotnost faze sledenja. Potrebne so dodatne kakovostne, s placebom kontrolirane raziskave, ki bi podale trdne dokaze o učinkovitosti TS-TŽ na populaciji oseb z UUI, ki se niso pozitivno odzvale na predhodno zdravljenje.

Keywords

magistrska dela;fizioterapija;sindrom prekomerno aktivnega sečnega mehurja;subjektivna ocena spremembe stanja;dnevnik uriniranja;električna stimulacija;tibialni živec;

Data

Language: Slovenian
Year of publishing:
Typology: 2.09 - Master's Thesis
Organization: UL ZF - University College of Health Studies
Publisher: [K. Stanonik]
UDC: 615.8
COBISS: 108682243 Link will open in a new window
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Other data

Secondary language: English
Secondary title: ǂThe ǂeffectiveness of transcutaneous electrical stimulation of the tibial nerve on the symptoms of urinary incontinence in women - a placebo controlled trial
Secondary abstract: Introduction: Urge urinary incontinence (UUI) is the most bothersome symptom of the Overactive Bladder Syndrome. Transcutaneous tibial nerve stimulation (TTNS) is a form of peripheral neural modulation that aims at indirect inhibition of unwanted contraction of the urinary bladder. Despite some evidence of TTNS efficacy, there is a lack of studies comparing active TTNS with sham stimulation. Purpose: The purpose of this master thesis is to compare efficacy of active TTNS with stimulation intensity above motor threshold with sham TTNS on subjective assessment of improvement. Methods: We included 31 women, diagnosed UUI that have been resistant to previous treatment, in this randomized, placebo controlled trial. The stimulation protocol consisted of six TTNS with stimulation intensity above motor threshold or six placebo TTNS. The primary outcome of the trial was improvement on the Global Impression of Improvement questionnaire. The secondary outcome was improvement on three-day bladder diary and International Consultation on Incontinence Questionnaire – Short Form. Results: Twenty-seven (87 %) women successfully completed the electric stimulation protocol. Three out of 16 women in the TTNS group and one out of 11 women in the placebo TTNS group reported that their symptoms have improved much or very much. We found no statistically significant difference between the groups regarding the symptom improvement (p = 0,624). No woman reported that her condition worsened after either TTNS or placebo stimulation. We found no statistically significant changes in secondary outcomes after the stimulation in either of the two groups. Discussion and conclusion: A protocol that consists of six TTNS does not result in statistically significant improvement of symptoms on population of women with UUI that have been resistant to previous treatment. One of the reasons for lack of the effect in our trial can be found in shorter TTNS duration in our trial when compared to other trials. The key limitations of our trial are: a small sample size, lack of therapists or assessors blinding and a lack of follow-up. Future high quality studies are necessary to provide robust evidence on effectiveness of TTNS on population with UUI that have been resistant to previous treatment.
Secondary keywords: master's theses;physiotherapy;overactive bladder syndrome;subjective assessment of change;bladder diary;electrical stimulation;tibial nerve;
Type (COBISS): Master's thesis/paper
Study programme: 0
Embargo end date (OpenAIRE): 1970-01-01
Thesis comment: Univ. v Ljubljani, Zdravstvena fak., Oddelek za fizioterapijo
Pages: 66 str., [13] str. pril.
ID: 15377156