Skip to main content
AAPM&R Events Main banner
JFK Johnson
Icon Legend
This session is not in your schedule.
This session is in your schedule. Click again to remove it.
Presentation Icons
In-Person
In-Person
On Demand
On Demand
Live Stream
Live Stream
Invite Only
Invite Only
Ticketed
Ticketed
Coffee Break
Coffee Break
Meal
Meal
Reception
Reception
Back

Neurological Rehabilitation

(Research Hub Theater) Survey Results of Home Neuromodulation for Neurogenic Bladder in Spinal Cord Injury

Friday, November 17, 2023
12:00 PM – 1:45 PM CT

    Primary Author(s)

  • Alexa Ryder, MD, MBA

    PM&R Resident
    McGovern Medical School At the University of Texas HSC At Houston
    Houston, Texas

    • Co-Author(s)

  • Argyrios Stampas, MD

    Associate Professor/Spinal Cord Injury Medicine Research Director
    UTHealth At Houston McGovern Medical School/TIRR Memorial Hermann
    Houston, Texas

Objective: Survey outcomes of a 3-month randomized control trial of transcutaneous tibial nerve stimulation (TTNS) to reduce overactive bladder medications (OABm) for people with spinal cord injury neurogenic bladder.

Design: Randomized sham-controlled trial

Setting: Community; SCI clinic

Participants: People with SCI performing intermittent catheterization and using OABm. 22 subjects in sham group; 20 in TTNS group.

Interventions: At home TTNS 5 days weekly for 3 months, with OABm reduction after 2 weeks, with medications decreased weekly as tolerated. Controls performed electric stimulation with sham settings.

Main Outcome Measures: Survey outcome measures reported for this abstract are adverse events, medication log, Neurogenic Bladder Symptom Score (NBSS), Incontinence Quality of Life (IQOL) Score, and the Anticholinergic Side Effect Survey at baseline and at 3-months.

Results: There were no baseline differences between groups based on NBSS, IQOL Score, and the Anticholinergic Side Effect Survey. After 12 weeks, Sham group had more complaints of hard stool than TTNS group (p=0.049). No other significant survey differences between groups. Within groups over time, the “Incontinence” (coeff. 2.6, p=0.01) and “Voiding and Storage” (coeff. 1.1, p=0.03) subscores of the NBSS worsened, but were not attributable to treatment allocation. 14 people were able to discontinue OABm, 40% (n=8) of the TTNS group and 27% (n=6) of the control group. At conclusion of the study, most people strongly agreed TTNS was easy to use, didn’t irritate skin, wasn’t painful, and wasn’t embarrassing to use. ~5% felt TTNS was embarrassing to use, painful, and wouldn’t switch to TTNS if it worked as well as medications. There were 4 adverse events (3 UTIs, 1 COVID infection), unrelated to TTNS use.

Conclusions: TTNS was safe and feasible, with overall positive user feedback. No major changes were seen in bladder surveys in the TTNS group, despite 40% of people discontinuing OABm. Further analyses of outcome measures are needed.