A feasibility study of transcutaneous posterior tibial nerve stimulation for bladder and bowel dysfunction in elderly adults in residential care

Joanne Booth, Suzanne Hagen, Doreen McClurg, Christine Norton, Carolyn MacInnes, Brigitte Collins, Cam Donaldson, Debbie Tolson

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To assess preliminary effects of a program of transcutaneous posterior tibial nerve stimulation (TPTNS) on lower urinary tract symptoms and number of episodes of urinary and fecal incontinence in older adults in residential care homes and the feasibility of a full-scale randomized trial.

DESIGN: Pilot randomized single-blind, placebo-controlled trial.

SETTING: Seven residential care homes and 3 sheltered accommodation complexes in the United Kingdom.

PARTICIPANTS: Thirty care home residents aged 65 and older with urinary or bowel symptoms and/or incontinence.

INTERVENTIONS: Twelve 30-minute sessions of TPTNS or sham stimulation (placebo).

MEASUREMENTS: Lower urinary tract symptoms using American Urological Society Symptom Index, urinary incontinence using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), postvoid residual urine volumes using portable bladder scanning, bowel symptoms and fecal incontinence using selected ICIQ questions.

RESULTS: Total American Urological Society Symptom Index scores improved, showing a median reduction of 7 (interquartile range [IQR] -8 to -3) in the TPTNS group and a median increase in the sham stimulation (placebo) group of 1 (IQR -1 to 4) (Mann-Whitney U 16.5000, Z -3.742, P < .001). Total ICIQ-SF scores improved by a median of 2 (IQR -6 to 0) in the TPTNS group and 0 points (IQR -3 to 3) in the sham stimulation group (Mann-Whitney U 65.000, Z -1.508, P = .132). Significant reduction was found in postvoid residual urine of 55 mL in the TPTNS group (t = -2.215, df 11.338, P = .048). Bowel urgency improved in 27% of the TPTNS group compared with 8% of the sham group (χ(2) 2.395, df 2, P > .302), fecal leakage improved in 47% of the TPTNS group compared with 23% of the sham group (χ(2) 4.480, df 2, P > .106); however, these differences were not significant. No adverse effects were reported by older adults or care staff.

CONCLUSION: TPTNS is safe and acceptable with evidence of potential benefit for bladder and bowel dysfunction in older male and female residents of care homes. Data support the feasibility of a substantive trial of TPTNS in this population.

Original languageEnglish
Pages (from-to)270-4
Number of pages5
JournalJournal of the American Medical Directors Association
Volume14
Issue number4
DOIs
Publication statusPublished - Apr 2013
Externally publishedYes

Fingerprint

Tibial Nerve
Feasibility Studies
Urinary Bladder
Home Care Services
Fecal Incontinence
Lower Urinary Tract Symptoms
Placebos
Urinary Incontinence
Homes for the Aged
Residual Volume
Referral and Consultation
Urine
Population

Keywords

  • Aged
  • Analysis of Variance
  • Feasibility Studies
  • Fecal Incontinence
  • Female
  • Great Britain
  • Homes for the Aged
  • Humans
  • Lower Urinary Tract Symptoms
  • Male
  • Middle Aged
  • Nursing Homes
  • Patient Satisfaction
  • Pilot Projects
  • Quality of Life
  • Single-Blind Method
  • Tibial Nerve
  • Transcutaneous Electric Nerve Stimulation
  • Treatment Outcome

Cite this

Booth, Joanne ; Hagen, Suzanne ; McClurg, Doreen ; Norton, Christine ; MacInnes, Carolyn ; Collins, Brigitte ; Donaldson, Cam ; Tolson, Debbie. / A feasibility study of transcutaneous posterior tibial nerve stimulation for bladder and bowel dysfunction in elderly adults in residential care. In: Journal of the American Medical Directors Association. 2013 ; Vol. 14, No. 4. pp. 270-4.
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A feasibility study of transcutaneous posterior tibial nerve stimulation for bladder and bowel dysfunction in elderly adults in residential care. / Booth, Joanne; Hagen, Suzanne; McClurg, Doreen; Norton, Christine; MacInnes, Carolyn; Collins, Brigitte; Donaldson, Cam; Tolson, Debbie.

In: Journal of the American Medical Directors Association, Vol. 14, No. 4, 04.2013, p. 270-4.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A feasibility study of transcutaneous posterior tibial nerve stimulation for bladder and bowel dysfunction in elderly adults in residential care

AU - Booth, Joanne

AU - Hagen, Suzanne

AU - McClurg, Doreen

AU - Norton, Christine

AU - MacInnes, Carolyn

AU - Collins, Brigitte

AU - Donaldson, Cam

AU - Tolson, Debbie

N1 - Copyright © 2013. Published by Elsevier Inc.

PY - 2013/4

Y1 - 2013/4

N2 - OBJECTIVE: To assess preliminary effects of a program of transcutaneous posterior tibial nerve stimulation (TPTNS) on lower urinary tract symptoms and number of episodes of urinary and fecal incontinence in older adults in residential care homes and the feasibility of a full-scale randomized trial.DESIGN: Pilot randomized single-blind, placebo-controlled trial.SETTING: Seven residential care homes and 3 sheltered accommodation complexes in the United Kingdom.PARTICIPANTS: Thirty care home residents aged 65 and older with urinary or bowel symptoms and/or incontinence.INTERVENTIONS: Twelve 30-minute sessions of TPTNS or sham stimulation (placebo).MEASUREMENTS: Lower urinary tract symptoms using American Urological Society Symptom Index, urinary incontinence using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), postvoid residual urine volumes using portable bladder scanning, bowel symptoms and fecal incontinence using selected ICIQ questions.RESULTS: Total American Urological Society Symptom Index scores improved, showing a median reduction of 7 (interquartile range [IQR] -8 to -3) in the TPTNS group and a median increase in the sham stimulation (placebo) group of 1 (IQR -1 to 4) (Mann-Whitney U 16.5000, Z -3.742, P < .001). Total ICIQ-SF scores improved by a median of 2 (IQR -6 to 0) in the TPTNS group and 0 points (IQR -3 to 3) in the sham stimulation group (Mann-Whitney U 65.000, Z -1.508, P = .132). Significant reduction was found in postvoid residual urine of 55 mL in the TPTNS group (t = -2.215, df 11.338, P = .048). Bowel urgency improved in 27% of the TPTNS group compared with 8% of the sham group (χ(2) 2.395, df 2, P > .302), fecal leakage improved in 47% of the TPTNS group compared with 23% of the sham group (χ(2) 4.480, df 2, P > .106); however, these differences were not significant. No adverse effects were reported by older adults or care staff.CONCLUSION: TPTNS is safe and acceptable with evidence of potential benefit for bladder and bowel dysfunction in older male and female residents of care homes. Data support the feasibility of a substantive trial of TPTNS in this population.

AB - OBJECTIVE: To assess preliminary effects of a program of transcutaneous posterior tibial nerve stimulation (TPTNS) on lower urinary tract symptoms and number of episodes of urinary and fecal incontinence in older adults in residential care homes and the feasibility of a full-scale randomized trial.DESIGN: Pilot randomized single-blind, placebo-controlled trial.SETTING: Seven residential care homes and 3 sheltered accommodation complexes in the United Kingdom.PARTICIPANTS: Thirty care home residents aged 65 and older with urinary or bowel symptoms and/or incontinence.INTERVENTIONS: Twelve 30-minute sessions of TPTNS or sham stimulation (placebo).MEASUREMENTS: Lower urinary tract symptoms using American Urological Society Symptom Index, urinary incontinence using International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), postvoid residual urine volumes using portable bladder scanning, bowel symptoms and fecal incontinence using selected ICIQ questions.RESULTS: Total American Urological Society Symptom Index scores improved, showing a median reduction of 7 (interquartile range [IQR] -8 to -3) in the TPTNS group and a median increase in the sham stimulation (placebo) group of 1 (IQR -1 to 4) (Mann-Whitney U 16.5000, Z -3.742, P < .001). Total ICIQ-SF scores improved by a median of 2 (IQR -6 to 0) in the TPTNS group and 0 points (IQR -3 to 3) in the sham stimulation group (Mann-Whitney U 65.000, Z -1.508, P = .132). Significant reduction was found in postvoid residual urine of 55 mL in the TPTNS group (t = -2.215, df 11.338, P = .048). Bowel urgency improved in 27% of the TPTNS group compared with 8% of the sham group (χ(2) 2.395, df 2, P > .302), fecal leakage improved in 47% of the TPTNS group compared with 23% of the sham group (χ(2) 4.480, df 2, P > .106); however, these differences were not significant. No adverse effects were reported by older adults or care staff.CONCLUSION: TPTNS is safe and acceptable with evidence of potential benefit for bladder and bowel dysfunction in older male and female residents of care homes. Data support the feasibility of a substantive trial of TPTNS in this population.

KW - Aged

KW - Analysis of Variance

KW - Feasibility Studies

KW - Fecal Incontinence

KW - Female

KW - Great Britain

KW - Homes for the Aged

KW - Humans

KW - Lower Urinary Tract Symptoms

KW - Male

KW - Middle Aged

KW - Nursing Homes

KW - Patient Satisfaction

KW - Pilot Projects

KW - Quality of Life

KW - Single-Blind Method

KW - Tibial Nerve

KW - Transcutaneous Electric Nerve Stimulation

KW - Treatment Outcome

U2 - 10.1016/j.jamda.2012.10.021

DO - 10.1016/j.jamda.2012.10.021

M3 - Article

VL - 14

SP - 270

EP - 274

JO - Journal of the American Medical Directors Association

JF - Journal of the American Medical Directors Association

SN - 1525-8610

IS - 4

ER -