Comparação dos efeitos das técnicas de eletroestimulação do nervo tibial e parassacral em mulheres com bexiga neurogênica hiperativa pós AVC: ensaio clínico randomizado e cego

Abstract

Introduction: An overactive neurogenic bladder (ONB) has a high prevalence among patients after stroke and results in damage to quality of life. Given the high cost and the intensity of the possible effects of medical treatment, physical therapy shows how an option is considered. Despite recent promising studies, little is known about the effects of electrostimulation on the treatment of ONB after stroke. Objective: Therefore, the aim of this study was to evaluate the effects of tibial (ESS) and parasacral nerve electrostimulation (EEPS) techniques in women with BNH after stroke. Methodology: This is a prospective clinical study comparing two randomized groups in parallel and single blind, sample of 22 women who after stroke developed BNH were recruited and divided into two groups: EENT group and EEPS group. Before and after the intervention, participants were evaluated for the impact of urinary incontinence by the ICIQ questionnaire, number of urinary doses and voiding frequency by the three-day voiding diary and quality of life using the WHOOQOL questionnaire. As participants, they underwent treatment for 12 sessions, twice weekly in both groups. No EENT group electrodes were positioned in the tibial region and no EEPS group in the parasacral region with F = 10Hz, T = 200 μs.for 30 minutes. The ANOVA repeated measures statistical test was applied to detect differences between the groups. Results: No interaction was found between group and time for UI impact variables [F (1.0, 1.0) = 2.14; p = 0.174] and urinary frequency [F (1.0, 1.0) = 4.43; p = 0.062]. A statistically significant interaction was found between group and time, with variable urinary variables [F (1.0, 1.0) = 6.80; p = 0.026]. As comparisons indicated that in the EEPS group there was a greater reduction in urinary losses at the end of the intervention compared to the initial value when compared to the EENT group. Quality of life assessment was found in no domain. Conclusion: The ETNS and EEPS techniques were used to treat ONB in women after stroke for reduced impact and urinary symptoms. The EEPS technique presented results superior to a reduction of urinary losses.