Comparing Pelvic Interferential Therapy and Posterior Tibial Nerve Stimulation for Neurogenic Detrusor Over Activity in Spinal Cord Injury.

Abstract

The Aim and objective of the study is to evaluate the comparative effectiveness of pelvic interferential therapy (PIFT) and transcutaneous posterior
tibial nerve stimulation (PTNS) on volume at first detrusor contraction, detrusor pressure of neurogenic detrusor overactivity (NDO), number of leakages
and incontinence on ICIQ-UI-SF scale in spinal cord injury patients (SCI) with neurogenic detrusor overactivity (NDO) associated incontinence. In this
randomized clinical trial, 33 SCI subjects with NDO with subjective complaints of frequent urination and leakages participated. Subjects were randomized
into 3 groups: Pelvic IFT (Group1), Transcutaneous PTNS (Group 2), and control (Group3). Electrical stimulation using interferential therapy and
transcutaneous posterior tibial nerve stimulation using TENS. Antimuscarinic drugs and behavioral training were given to both group 1 and group 2. Electrical
stimulation was given to both groups for 20 minutes 5 times a week for 4 weeks. At the same time, the control group (group 3) received only antimuscarinic
drugs and behavioral training. Pre-intervention and post-intervention recording of the urodynamic study (UDS) was performed, and volume at first detrusor
contraction and detrusor pressure was noted. Subjects were asked to complete the ICIQ-UI-SF scale before and after the treatment for several leakages and
incontinence measurements. On comparing the three groups, there is no statistically significant difference in several leakages, detrusor pressure, and volume
at first detrusor contraction, which means all three treatments had the same effect on these outcomes. Still, there is a statistically significant difference in
incontinence. The mean value of PIFT (Group1) is lesser than PTNS (Group-2) and control (Group-3). Pelvic Interferential therapy is clinically more effective
in reducing urinary incontinence episodes than transcutaneous posterior tibial nerve stimulation and anticholinergic drugs in patients with spinal cord injury.
Pelvic Interferential therapy is easy to use, clinically effective, and safe with no significant side effects, and it can be easily combined with antimuscarinic drugs
and behavioral training.