Improvement of quality of life in children with slow transit constipation after treatment with transcutaneous electrical stimulation

Clarke, Melanie C. C.; Chase, Janet; Gibb, Susan; Hutson, John M.; Southwell, Bridget R.

doi:10.1016/j.jpedsurg.2009.02.031

Cited by 71 publications

(74 citation statements)

References 35 publications

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“…51 While this is true, it unfortunately means that children in the placebo arm face the prospect of lack of effective therapy for some time, which potentially impacts on their future well-being from the social and developmental ramifications of constipation and fecal incontinence. 37 It may be, therefore, preferable to keep the placebo-controlled studies confined to adults. The theory that interferential current therapy works by creating a third therapeutic current at the point of bisection is appealing in that it targets places that have previously been relatively inaccessible.…”

Section: Discussionmentioning

confidence: 99%

“…However, the fact propagating sequences increased in a small group of children after treatment does suggest it may impact on the enteric nervous system potentially affecting overall neuronal health. 37 This theory was postulated by the fact that effects took some time to develop, and lasted long after therapy had been ceased. As mentioned earlier, it is possible interferential current therapy stimulates motor and sensory spinal nerves, and/or the parasympathetic and sympathetic nerves, the interstitial cells of Cajal and/or other enteric nerves within the bowel wall.…”

Section: Discussionmentioning

confidence: 99%

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Neuromodulation via Interferential Electrical Stimulation as a Novel Therapy in Gastrointestinal Motility Disorders

Moore

Burgell

2018

J Neurogastroenterol Motil

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The concept of therapeutic percutaneous neuromodulation has, until recently, been limited by the ability to penetrate deeply enough to stimulate internal organs. By utilizing 2 medium frequency, slightly out of phase electrical currents passing diagonally through the abdomen, a third, low frequency current is created at the point of bisection. This interferential current appears to stimulate nerve fibers in the target organs and may have a therapeutic action. The aim of the study is to review the use of transcutaneous interferential electrical stimulation with a focus on its application in gastroenterology, particularly in motility disorders. Studies involving use of interferential current therapy were searched from Medline, PubMed, and Scopus databases, and articles pertaining to history, its application and all those treating abdominal and gastrointestinal disorders were retrieved. Seventeen studies were identified, 13 involved children only. Eleven of these were randomised controlled trials (3 in adults). Four trials were from the one center, where each paper reported on different outcomes such as soiling, defecation frequency, quality of life, and colon transit studies from the one pool of children. All studies found statistically significant improvement in symptom reduction. However, weaknesses in study design were apparent in some. In particular, finding an adequate placebo to interferential current therapy has been difficult. Interferential current therapy shows potential as a novel, non-pharmacological and economical means of treating gastrointestinal dysfunction such as constipation. More studies are needed particularly in the adult population. However, the design of a suitable placebo is challenging. Search MethodA search of Medline, PubMed, and Scopus databases for information on electrical interferential current and its application using search words such as "electrical interferential current," "transcutaneous," "therapeutics or uses," "mechanisms of action," and "gastrointestinal" was performed. Articles that were available in English were included. This review focuses on the use of transcutaneous interferential current therapy in the treatment of gastrointestinal symptoms. The Nature of Interferential Current TherapyInterferential current therapy has been used in a variety of settings including low back pain 11 and neurological disorders such as carpal tunnel syndrome. 12 More recently, interferential current therapy has been found to be effective in small studies in managing conditions such as fecal incontinence and constipation. It has the benefit of being completely non-invasive, cost effective and convenient, as it can be self-administered at home. 13Despite increased convenience to the patient, doctor and payer, the use of transcutaneously-delivered current can be problematic. To stimulate the nerve of interest, the current has to pass through the skin and surrounding muscle to reach its target. This causes resistance to flow, requiring the use of a higher current to achieve the desired resu...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Neuromodulation via Interferential Electrical Stimulation as a Novel Therapy in Gastrointestinal Motility Disorders

Moore

Burgell

2018

J Neurogastroenterol Motil

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“…The posterior tibial nerve finds its roots in the sacral plexus and with PTNS and TENS this nerve is stimulated at the level of the ankle. [22][23][24] In PTNS a very fine needle is inserted in the tibial nerve posterior to the medial malleolus. An electrical impulse is given through this needle over a period of 30 minutes on a weekly basis.…”

Section: Amplitudementioning

confidence: 99%

“…With this technique a self-adhesive electrode is used on the on the belly and back at the level of the umbilicus. [22][23][24] …”

Section: Amplitudementioning

confidence: 99%

Successful sacral nerve modulation despite migration of tined lead

Dekkers

Schmitz

Heyden

et al. 2016

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Background: Sacral nerve modulation (SNM) is a minimally invasive treatment for chronic constipation or incontinence when conservative treatment is insufficient to provide relieve of symptoms. Case description: A 74-year-old patient with an implanted sacral nerve lead is presented in this case report with a dislodged lead without an adverse change in her incontinence treatment. This phenomenon has never been described before and raises the debate on sacral lead positioning in sacral nerve stimulation. Discussion: There are a lot of conflicting data regarding ideal lead positioning, such as S3 versus S2 or S4 implantation. The lead position in our case doesn't correspond to previously described locations and pathways which corroborate the legitimacy of new developments in this area such as percutaneous tibial nerve stimulation, transcutaneous tibial nerve stimulation and transcutaneous abdominal electrical stimulation (TEN). Conclusions: The implantation of SNM seems standardized but leaves voids in the technique where further research is needed to refine it.

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“…Kabızlığın tedavisi ile çocuklarda davranış problemlerinin azaldığına yönelik çalışmalar bulunmakla birlikte [15][16][17][18] yaşam kalitesinin yükseldiğine dair veriler çok daha sınırlıdır. Yakın tarihli iki çalışma transkutanöz elektrik stimulasyonunun yavaş geçişli konstipasyonda [19] ve malone antegrade continence enema (MACE) prosedürünün ise inatçı tekrarlayan kabızlık veya enkopreziste [20] yaşam kalitesini artırdığını göstermiştir. Ancak bu iki yöntem de ancak seçilmiş hastalarda uygulanabilen ve FK'nın standart tedavisi olarak kabul edilemeyecek yaklaşımlardır.…”

unclassified

Çocuklarda fonksiyonel kabızlık tedavisinin yaşam kalitesi üzerine etkisi

Kilincaslan¹,

Abali²,

Aydoğdu³

et al. 2014

MMJ

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GirişFonksiyonel kabızlık (FK) sık görülen bir patolojidir ve bu hastalar genel pediatri polikliniklerine başvuruların % 3'ünü, pediatrik gastroenteroloji polikliniğine başvuranların ise % 25'ini oluşturur [1]. Yakın dönemde gerçekleştirilen iki ayrı çalışmada FK'nın genel popülasyondaki çocuklarda % 5-18 oranında görüldüğü bildirilmiştir [2,3]. Hastaların yaklaşık yarısında belirtilerin ilk bir yılda başladığı, ortalama başlangıç yaşının 2 olduğu ve en sık olarak 2 ve 4-5 yaş arasındaki çocuklarda görüldüğü bildirilmektedir [4,5]. FK sıklıkla tekrarlayıcı bir durumdur: beş yıllık izlemde hastaların üçte biri ile yarısında tedaviye rağmen şikayetlerin sürdüğü, dörtte birinde ise erişkinlik dönemine kadar belirtilerin devam ettiği gösterilmiştir [6]. Bulgular: Annelerin algıladığı toplam yaşam kalitesi tedavinin 6. haftasının sonunda başlangıca kıyasla anlamlı düzeyde artış gösterdi (82,87 ± 13,91'e karşı 74,24 ± 15,40, p < 0,001) ve tüm alanlardaki artış anlamlı düzeydeydi. Ayrıca annelerin psikolojik zorlanma düzeylerini yansıtan global şiddet indeksi (GŞİ) puanlarında da belirgin azalma (1,09 ± 0,76'e karşı 0,78 ± 0,64, p<0,001) bildirildi. Fiziksel, sosyal ve toplam yaşam kalitesi puanlarındaki fark annelerin GŞİ puanları istatistiksel olarak kontrol edildiğinde de korundu.Sonuç: Hastalarımızda tüm yaşam kalitesi alanlarında ve toplam puanda belirgin artış gözlendi. Kabızlık belirtilerindeki azalma, fiziksel sağlık ve sosyal alandaki iyileşmeyi direkt olarak etkilerken, duygusal işlevsellikteki iyileşme, annelerin psikolojik zorlanmasının azalması ile ilişkili, dolaylı bir etki olduğu görülmektedir. Anahtar kelimeler: Fonksiyonel kabızlık, Yaşam kalitesi, Okul öncesi çocuklar, TedaviABSTRACT Objective: The aim of this study was to determine whether there is a change in the quality of life (QOL) in preschool children with functional constipation (FC) after undergoing standard treatment.Patients and Methods: Sixty-five patients, between 2-6 years of age, with FC, were included in the study. The mothers completed the Pediatric Quality of Life (QOL) Inventory and Symptom Checklist-90-Revised (SCL-90-R) before starting the treatment and at the 6th week of the treatment. The change in QOL and SCL-90-R scores were compared using repeated measures ANOVA and Wilcoxon tests.Results: Mother-perceived total QOL was improved at 6th week of treatment compared with baseline (82.87 ± 13.91 vs 74.24 ± 15.40, p < 0.001) and improvement in all domains of QOL was significant. A significant decrease in the global severity index (GSI) of maternal psychological distress (1.09 ± 0.76 vs 0.78 ± 0.64, p<0.001) was also reported. Improvement in physical, social and total QOL was maintained after GSI scores of the mothers were statistically controlled.Conclusion: Significant improvement in all QOL categories was detected. Decrease in symptoms of constipation seemed to effect physical and social aspects of QOL directly, whereas improvement in emotional functioning seemed rather be an indirect effect of treatment via decrease in psycholog...

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Improvement of quality of life in children with slow transit constipation after treatment with transcutaneous electrical stimulation

Cited by 71 publications

References 35 publications

Neuromodulation via Interferential Electrical Stimulation as a Novel Therapy in Gastrointestinal Motility Disorders

Neuromodulation via Interferential Electrical Stimulation as a Novel Therapy in Gastrointestinal Motility Disorders

Successful sacral nerve modulation despite migration of tined lead

Çocuklarda fonksiyonel kabızlık tedavisinin yaşam kalitesi üzerine etkisi

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