Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele

Kajbafzadeh, Abdol‐Mohammad; Sharifi‐Rad, Lida; Nejat, Farideh; Kajbafzadeh, Majid; Talaei, Hamid-Reza

doi:10.1007/s00384-011-1328-z

Cited by 42 publications

(51 citation statements)

References 20 publications

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“…Moreover, a study by Kajbafzadeh et al [6] who reported that, Although IF electrical stimulation did not apply on pelvic floor muscles directly, modulation of sacral reflexes occurs improving the bowel control after using IF stimulation technique.…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Lower Abdominal Kinesio Taping Plus Interferential Electrical Stimulation Techniques in the Improvement Of Bowel Control in Meningomyelocele Children

Azam¹

2017

JPNC

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Objectives: This work was carried out to investigate the efficacy of lower abdominal kinesio taping plus interferential electrical stimulation techniques in the improvement of bowel control in meningomyelocele children.Method: 30 children were randomly selected into two groups; group A (lower abdominal kinsotaping plus I.F. current stimulation techniques plus routine traditional physiotherapy program), and group B (routine traditional physiotherapy program only). Children engaged in this study received baseline and post-treatment evaluation using defecation frequency test (DF), visual analog scale (VAS), constipation score system (CSS) to evaluate defecations numbers/ week, events of abdominal pain and changes in bowel control. The parents in the two groups A and B were given instructions for the home routine program.Results: Data analysis was available on the 30 meningomyelocele children participated in the study. The difference between pre and post-treatment results was significant in the study group in all variables. By comparison of the two groups in DF at post-treatment, there was a suggestive promotion in defecation frequency (DF) (p<.05). By comparison of the two groups in abdominal pain at post-treatment, there was a significant decrease in abdominal pain measured (p<.05). By comparison of the two groups in constipation score system at posttreatment, there was a suggestive promotion in bowel control (p<.05). Conclusion:According to the results of this study, it can be concluded that the combined effect of lower abdominal kinesio taping plus interferential electrical stimulation techniques in addition to routine traditional physiotherapy program was better than routine traditional physiotherapy program along and can be recommended in improvement bowel control in meningomyelocele children.

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Section: Discussionmentioning

confidence: 99%

“…Deep electrical stimulation by using interferential current stimulates the skin nerve fibers which can lead to facilitation of the parasympathetic nerve fibers and modulate the sacral reflexes controlling the bowel movment [5,6].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Lower Abdominal Kinesio Taping Plus Interferential Electrical Stimulation Techniques in the Improvement Of Bowel Control in Meningomyelocele Children

Azam¹

2017

JPNC

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“…This is difficult to accomplish as sham stimulation so far has been applied via no current passing between electrodes with the participant being told that the current is subsensory. 23,38 This may convince children, but is less likely to do so in adults. These studies also required participants to come in to the clinic for treatment, which also makes it easier for an investigator to create a realistic sham scenario, whereas more recent devices are small enough for patients to take home and use.…”

Section: Discussionmentioning

confidence: 99%

“…Thirty Iranian children with neuronal bowel dysfunction from myelomeningocele participated in a randomized controlled trial. 38 Constipation, as determined by stool form, decreased and the neurogenic bowel dysfunction scores improved from 'moderate' to 'mild' in the interferential current therapy group. These results were noted at 6 months after receiving treatment with an overall improvement in 73% of the children in the interferential current therapy group.…”

mentioning

confidence: 89%

“…In this group, it was suggested that the therapeutic action maybe more than just improved colonic transit time, and it was postulated that pelvic floor muscle fibers may be strengthened or that there may be neuromodulation of the sacral reflexes as seen in patients with urinary and fecal incontinence. 38 Anorectal manometric indices also improved with a significant reduction in both sphincter pressure and the recto-anal inhibitory reflex, although it is not clear what the clinical significance of this is, as normal reference ranges are still debated. 39 Two recent studies have explored the efficacy of interferential stimulation in conditions related to anal sphincter function.…”

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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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Neurogenic bowel dysfunction: Clinical management recommendations of the Neurologic Incontinence Committee of the Fifth International Consultation on Incontinence 2013

Cotterill

Madersbacher

Wyndaele

et al. 2017

Neurourology and Urodynamics

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Background Evidence‐based guidelines for the management of neurological disease and lower bowel dysfunction have been produced by the International Consultations on Incontinence (ICI). These are comprehensive guidelines, and were developed to have world‐wide relevance. Aims To update clinical management of neurogenic bowel dysfunction from the recommendations of the 4th ICI, 2009. Materials and Methods A series of evidence reviews and updates were performed by members of the working group. The resulting guidelines were presented at the 2012 meeting of the European Association of Urology for consultation, and modifications applied to deliver evidence based conclusions and recommendations for the scientific report of the 5th edition of the ICI in 2013. Results The current review is a synthesis of the conclusions and recommendations, including the algorithms for initial and specialized management of neurogenic bowel dysfunction. The pathophysiology is described in terms of spinal cord injury, multiple sclerosis, and Parkinson's disease. Assessment requires detailed history and clinical assessment, general investigations, and specialized testing, if required. Treatment primarily focuses on optimizing stool consistency and regulating bowel evacuation to improve quality of life. Symptom management covers conservative and interventional measures to promote good habits and assist stool evacuation, along with prevention of incontinence. Education is essential to achieving optimal bowel management. Discussion The review offers a pragmatic approach to management in the context of complex pathophysiology and varied evidence base.

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Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele

Abstract: This pilot study showed that IF therapy is safe, noninvasive, and effective modality to improve constipation symptoms and anorectal manometry parameters in children with history of myelomeningocele.

Cited by 42 publications

References 20 publications

Efficacy of Lower Abdominal Kinesio Taping Plus Interferential Electrical Stimulation Techniques in the Improvement Of Bowel Control in Meningomyelocele Children

Efficacy of Lower Abdominal Kinesio Taping Plus Interferential Electrical Stimulation Techniques in the Improvement Of Bowel Control in Meningomyelocele Children

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

Neurogenic bowel dysfunction: Clinical management recommendations of the Neurologic Incontinence Committee of the Fifth International Consultation on Incontinence 2013

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