Transcutaneous Tibial Nerve Stimulation in Patients With Neurogenic Overactive Bladder After Stroke

NCT ID: NCT06385769

Last Updated: 2024-04-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

22 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-04-22

Study Completion Date

2026-02-28

Brief Summary

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The investigators conducted a prospective, randomized, double-blind, placebo-controlled study based on the placebo technique to evaluate the efficacy of TTNS versus placebo in patients with OAB after stroke.

The main questions aimed to be answered are:

What are the effects of Trans Tibial Nerve Stimulation (TTNS) on incontinence-related clinical parameters and quality of life in patients with overactive bladder (OAB) after stroke compared to the placebo group? Participants (n:22) with post-stroke AAM who meet the exclusion and inclusion criteria will be divided into 2 groups using a randomization table. The first group will receive TTNS (n:11) and the second group will receive placebo TTNS (n:11). Measurements will be performed twice in total, before treatment and at the end of treatment (4th week).

Detailed Description

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Conditions

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Urinary Bladder, Overactive

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Transcutaneous tibial nerve stimulation (TTNS)

In this study, one channel of the stimulation device will provide active stimulation to the patient, while the second channel will not be connected. The patient won't know which channel is active. Both channels will use continuous mode with a pulse frequency of 20 Hz and a pulse width of 200 ms. The intensity for the active channel will be adjusted based on comfort level and observed hallux reaction. Treatment includes 20 sessions of 30 minutes each, administered five times a week for four weeks.

Group Type EXPERIMENTAL

Transcutaneous tibial nerve stimulation (TTNS)

Intervention Type OTHER

The TTNS will be conducted unilaterally, with the patient in a supine position, using a surface electrode dual stimulation channel stimulation device. Two self-adhesive round surface electrodes will be positioned with the negative electrode 2 cm behind the medial malleolus and the positive electrode 10 cm proximal to it. The ground electrode will be placed on the ipsilateral limb. Channel 1 will provide active stimulation, while channel 2 will remain inactive.

Sham Transcutaneous tibial nerve stimulation (TTNS)

In the placebo group, the same electrotherapy device and settings as the active group will be used. One channel will not be connected to the patient but will display treatment details on the screen. The other channel will be connected but deliver no stimulation. Intensity for the inactive channel is limited to 2-3 mA. Patients will be informed that exceeding this threshold is prevented. Treatment includes 20 sessions of 30 minutes each, administered twice a week for four weeks.

Group Type SHAM_COMPARATOR

Sham Transcutaneous tibial nerve stimulation (TTNS)

Intervention Type OTHER

Sham TTNS group will be stimulated using the same electrotherapy device, with patients positioned identically and electrodes placed in the same positions as in the TTNS group. The current characteristics (pulse frequency 20 Hz and pulse width 200 ms) will also remain consistent across both channels. The second channel of the stimulation device will be designated as the channel connected to the patient but without delivering stimulation.

Interventions

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Transcutaneous tibial nerve stimulation (TTNS)

The TTNS will be conducted unilaterally, with the patient in a supine position, using a surface electrode dual stimulation channel stimulation device. Two self-adhesive round surface electrodes will be positioned with the negative electrode 2 cm behind the medial malleolus and the positive electrode 10 cm proximal to it. The ground electrode will be placed on the ipsilateral limb. Channel 1 will provide active stimulation, while channel 2 will remain inactive.

Intervention Type OTHER

Sham Transcutaneous tibial nerve stimulation (TTNS)

Sham TTNS group will be stimulated using the same electrotherapy device, with patients positioned identically and electrodes placed in the same positions as in the TTNS group. The current characteristics (pulse frequency 20 Hz and pulse width 200 ms) will also remain consistent across both channels. The second channel of the stimulation device will be designated as the channel connected to the patient but without delivering stimulation.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Patients aged 40 and above with stable ischemic or hemorrhagic stroke.
* Patients with neurogenic detrusor overactivity symptoms accompanied by urinary incontinence complaints and a urinary frequency of 9 or more.
* Patients diagnosed with detrusor overactivity on urodynamic evaluation.
* Patients with hemiplegia lasting between 30 days and 1 year.
* Ability to understand procedures, benefits, and potential side effects.
* Patients scoring 22 or above on the Mini Mental Test.

Exclusion Criteria

* Patients with post-stroke neurogenic detrusor overactivity receiving or previously received pharmacological treatment.
* Patients using intermittent catheterization or permanent catheterization as a bladder emptying method.
* Patients with a history of urinary incontinence and/or urinary retention before stroke.
* History of past urogynecological surgery.
* Presence of urinary tract infection, bladder tumor, or cardiac pacemaker.
* Significant fluid infusion requirement affecting urination or use of medication affecting bladder function.
* Patients who have received botulinum toxin injection for post-stroke neurogenic detrusor overactivity.
* Patients with postvoid residual volume above 150 mL.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Pamukkale University

OTHER

Sponsor Role lead

Responsible Party

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Necmettin Yildiz

Professor Doctor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Necmettin Yıldız, Prof.

Role: STUDY_DIRECTOR

Pamukkale University

Locations

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Pamukkale University

Denizli, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

Central Contacts

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Emre Bezmez, M.D.

Role: CONTACT

+905319902220

References

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Other Identifiers

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PamukkaleU.ftr-NYıldız-3

Identifier Type: -

Identifier Source: org_study_id

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