A Feasibility Study of Transcutaneous Posterior Tibial Nerve Stimulation for Bladder and Bowel Dysfunction in Elderly Adults in Residential Care

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

doi:10.1016/j.jamda.2012.10.021

Cited by 55 publications

(89 citation statements)

References 14 publications

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“…It modulates the sacral nerve plexus indirectly via the posterior tibial nerve, a branch of the sciatic nerve, which originates from the same segment in the spine as the nerves to the bladder and pelvic floor. 35 The exact mechanisms of action are not known; however, positive results have been observed in treating OAB and UI as well as fecal incontinence. 35 Seventy patients, 51 women and 19 men (final n = 66: 4 were lost to follow-up; sex was not specified) were evaluated in a single-group design, and TPTNS was applied unilaterally via electrodes behind the right medial malleolus.…”

Section: Discussionmentioning

confidence: 99%

“…35 The exact mechanisms of action are not known; however, positive results have been observed in treating OAB and UI as well as fecal incontinence. 35 Seventy patients, 51 women and 19 men (final n = 66: 4 were lost to follow-up; sex was not specified) were evaluated in a single-group design, and TPTNS was applied unilaterally via electrodes behind the right medial malleolus. Patients were taught to use the device at home for 20 minutes daily for 3 months.…”

Section: Discussionmentioning

confidence: 99%

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Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

Block¹,

Rivera²,

Melnick³

et al. 2015

International Journal of MS Care

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Background: Multiple sclerosis (MS) presents with many debilitating symptoms, including urinary incontinence (UI), that physical therapy (PT) may address; UI is widely prevalent, but PT management of symptoms lacks consensus. A meta-analysis of long-term nonsurgical and nonpharmaceutical treatment options may supply this deficiency. We analyzed the current evidence for effectiveness of PT to decrease UI and improve quality of life (QOL) in people with MS.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

Block¹,

Rivera²,

Melnick³

et al. 2015

International Journal of MS Care

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“…These became the reference points for the testing and refinement of our theories. There were some novel interventions that offered a potential way forward, for example transcutaneous posterior tibial nerve stimulation, 155,156,165,208 but the studies were small, provided insufficient detail or excluded people with dementia. The lack of an explicit articulation of theory or discussion of the theoretical underpinnings in much of the evidence reviewed is, however, a limitation and may mean that our interpretation of how and why certain interventions were developed is open to challenges of bias.…”

Section: Strengths and Limitations Of The Reviewmentioning

confidence: 99%

“…87,220 It is recognised that it is not possible to discuss FI without addressing constipation and that often there is interplay between FI, constipation and UI. Interventions in the research reviewed to date include, staff training, education and workforce cohesion and job satisfaction, 213,222 interventions that improve functional ability, 96 tibial nerve stimulation, 155 medication review, 28,112 and environmental and system changes that make it easier for residents to use toilets and to remove clothing. 115,178,220 Person-centred care for people with dementia living in care homes…”

Section: Summary Of Scoping Findingsmentioning

confidence: 99%

“…133 154 There were two small care home studies that tested the feasibility of novel interventions for addressing constipation using transcutaneous posterior tibial nerve stimulation 155 and mechanical vibration to provide abdominal massage. 156 Neither included PLWD and it was unclear who, apart from the research team, were involved and how the interventions could be implemented by care home staff for PLWD.…”

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confidence: 99%

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Managing Faecal INcontinence in people with advanced dementia resident in Care Homes (FINCH) study: a realist synthesis of the evidence

Goodman

Norton

Buswell

et al. 2017

Health Technol Assess

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BackgroundEighty per cent of care home residents in the UK are living with dementia. The prevalence of faecal incontinence (FI) in care homes is estimated to range from 30% to 50%. There is limited evidence of what is effective in the reduction and management of FI in care homes.ObjectiveTo provide a theory-driven explanation of the effectiveness of programmes that aim to improve FI in people with advanced dementia in care homes.DesignA realist synthesis. This was an iterative approach that involved scoping of the literature and consultation with five stakeholder groups, a systematic search and analysis of published and unpublished evidence, and a validation of programme theories with relevant stakeholders.Data sourcesThe databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Scopus, SocAbs, Applied Social Sciences Index and Abstracts, BiblioMap, Sirius, OpenGrey, Social Care Online and the National Research Register.ResultsThe scoping identified six programme theories with related context–mechanism–outcome configurations for testing. These addressed (1) clinician-led support, assessment and review, (2) the contribution of teaching and support for care home staff on how to reduce and manage FI, (3) the causes and prevention of constipation, (4) how the cognitive and physical capacity of the resident affect outcomes, (5) how the potential for recovery, reduction and management of FI is understood by those involved and (6) how the care of people living with dementia and FI is integral to the work patterns of the care home and its staff. Data extraction was completed on 62 core papers with iterative searches of linked literature. Dementia was a known risk factor for FI, but its affect on the uptake of different interventions and the dementia-specific continence and toileting skills staff required was not addressed. Most care home residents with FI will be doubly incontinent and, therefore, there is limited value in focusing solely on FI or on single causes of FI such as constipation. Clinical assessment, knowledge of the causes of FI and strategies that recognise the individuals’ preferences are necessary contextual factors. Valuing the intimate and personal care work that care home staff provide to people living with dementia and addressing the dementia-related challenges when providing continence care within the daily work routines are key to helping to reduce and manage FI in this population.LimitationsThe synthesis was constrained by limited evidence specific to FI and people with dementia in care homes and by the lack of dementia-specific evidence on continence aids.ConclusionsThis realist synthesis provides a theory-driven understanding of the conditions under which improvement in care for care home residents living with dementia and FI is likely to be successful.Future workFuture multicomponent interventions need to take account of how the presence of dementia affects the behaviours and choices of those delivering and receiving continence care within a care home environment.Study registrationThis study is registered as PROSPERO CRD42014009902.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Electrical stimulation with non-implanted electrodes for overactive bladder in adults

Stewart

Gameiro

Dib

et al. 2016

Cochrane Database of Systematic Reviews

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A Feasibility Study of Transcutaneous Posterior Tibial Nerve Stimulation for Bladder and Bowel Dysfunction in Elderly Adults in Residential Care

Cited by 55 publications

References 14 publications

Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

Do Physical Therapy Interventions Affect Urinary Incontinence and Quality of Life in People with Multiple Sclerosis?

Managing Faecal INcontinence in people with advanced dementia resident in Care Homes (FINCH) study: a realist synthesis of the evidence

Electrical stimulation with non-implanted electrodes for overactive bladder in adults

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