Efeito de diferentes correntes de eletroestimulação no nervo tibial em mulheres com incontinência urinária: ensaio controlado aleatorizado
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Data
2021-02-26
Autores
Avramidis, Raissa Escandiusi
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Essa dissertação é um requisito obrigatório para obtenção do título de Mestre em Desenvolvimento Humano e Tecnologias, pós-graduação oferecida pelo Instituto de Biociências – Universidade Estadual Paulista “Júlio de Mesquita Filho” – UNESP. Serão apresentados, separadamente, dois artigos. O primeiro artigo produzido foi um protocolo de estudo, que visa instruir metodologicamente novos estudos com eletroterapia na incontinência urinária por urgência. O segundo artigo redigido foi um Ensaio Controlado Aleatorizado, onde a metodologia foi baseada no primeiro artigo e no Consort. OBJETIVOS: Comparar os efeitos da aplicação de correntes de baixa frequência e média frequência e verificar qual corrente é mais eficaz para reduzir os sintomas e aumentar qualidade de vida durante o tratamento de mulheres com incontinência urinária por urgência. METODOLOGIA: Este é um ensaio clínico randomizado, avaliador e estatístico cego. Todas as 105 participantes foram submetidas a um protocolo de anamnese que incluiu coleta de dados pessoais e clínicos, aplicação de questionários específicos para incontinência urinária e qualidade de vida e avaliação física do assoalho pélvico. O protocolo foi realizado em três diferentes momentos: antes da intervenção, durante e na última sessão. As participantes foram alocadas em um dos 5 grupos (Transcutaneous Tibial Nerve Stimulation – Low Frequency, Transcutaneous Tibial Nerve Stimulation – High Frequency, Aussie Medium Frequency, Interferential Medium Frequency e High Voltage Stimulation) de maneira aleatorizada. Todos os grupos receberam a intervenção elétrica transcutânea para estimulação do nervo tibial por 30 minutos, por meio de um canal com dois eletrodos, um posicionado posteriormente ao maléolo medial e o outro 10 cm acima dele, por 20 sessões de 2 a 3 vezes por semana. RESULTADOS: Este estudo demonstrou que todas as cinco correntes utilizadas foram capazes de reduzir a gravidade da incontinência urinária e aumentar a qualidade de vida, com maiores ganhos observados entre a primeira e segunda avaliação. Não houve diferença significativa entre a segunda e a terceira avaliação (p > 0,005). Também não houve diferença significativa em relação à comparação entre os grupos (p > 0,005). CONCLUSÃO: O tratamento com correntes de baixa frequência obteve resultados similares aos da média frequência para a redução da severidade da incontinência urinária por urgência e aumento da qualidade de vida. Nenhuma modalidade de corrente foi superior para o tratamento da incontinência urinária por urgência.
Introduction: This dissertation is a mandatory requirement to obtain the title of Master in Human Development and Technologies, postgraduate offered by the Institute of Biosciences - Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP. Two articles will be presented separately. The first article produced was a study protocol, which aims to methodologically instruct new studies with electrotherapy in urinary incontinence by urgency. The second article written was a Randomized Controlled Trial, where the methodology was based on the first article and the Consort. OBJECTIVES: To compare the effects of applying low frequency and medium frequency currents and to see which current is most effective in reducing symptoms and increasing quality of life during the treatment of women with urinary incontinence. METHODOLOGY: This is a randomized clinical trial, evaluator and blind statistic. All 105 participants underwent an anamnesis protocol that included collection of personal and clinical data, application of specific questionnaires for urinary incontinence and quality of life and physical assessment of the pelvic floor. The protocol was performed at three different times: before the intervention, during and in the last session. The participants were randomly allocated to one of the 5 groups (Transcutaneous Tibial Nerve Stimulation - Low Frequency, Transcutaneous Tibial Nerve Stimulation - High Frequency, Aussie Medium Frequency, Interferential Medium Frequency and High Voltage Stimulation). All groups received transcutaneous electrical intervention to stimulate the tibial nerve for 30 minutes, through a channel with two electrodes, one positioned posteriorly to the medial malleolus and the other 10 cm above it, for 20 sessions 2 to 3 times a week. RESULTS: This study demonstrated that all five streams used were able to reduce the severity of urinary incontinence and increase quality of life, with greater gains observed between the first and the second assessment. There was no significant difference between the second and third assessments (p> 0.005). There was also no significant difference in comparison between groups (p> 0.005). CONCLUSION: Treatment with low frequency currents obtained results similar to those of medium frequency for reducing the severity of urinary incontinence due to urgency and increasing quality of life. No current modality was superior for the treatment of urinary incontinence by urgency.
Introduction: This dissertation is a mandatory requirement to obtain the title of Master in Human Development and Technologies, postgraduate offered by the Institute of Biosciences - Universidade Estadual Paulista “Júlio de Mesquita Filho” - UNESP. Two articles will be presented separately. The first article produced was a study protocol, which aims to methodologically instruct new studies with electrotherapy in urinary incontinence by urgency. The second article written was a Randomized Controlled Trial, where the methodology was based on the first article and the Consort. OBJECTIVES: To compare the effects of applying low frequency and medium frequency currents and to see which current is most effective in reducing symptoms and increasing quality of life during the treatment of women with urinary incontinence. METHODOLOGY: This is a randomized clinical trial, evaluator and blind statistic. All 105 participants underwent an anamnesis protocol that included collection of personal and clinical data, application of specific questionnaires for urinary incontinence and quality of life and physical assessment of the pelvic floor. The protocol was performed at three different times: before the intervention, during and in the last session. The participants were randomly allocated to one of the 5 groups (Transcutaneous Tibial Nerve Stimulation - Low Frequency, Transcutaneous Tibial Nerve Stimulation - High Frequency, Aussie Medium Frequency, Interferential Medium Frequency and High Voltage Stimulation). All groups received transcutaneous electrical intervention to stimulate the tibial nerve for 30 minutes, through a channel with two electrodes, one positioned posteriorly to the medial malleolus and the other 10 cm above it, for 20 sessions 2 to 3 times a week. RESULTS: This study demonstrated that all five streams used were able to reduce the severity of urinary incontinence and increase quality of life, with greater gains observed between the first and the second assessment. There was no significant difference between the second and third assessments (p> 0.005). There was also no significant difference in comparison between groups (p> 0.005). CONCLUSION: Treatment with low frequency currents obtained results similar to those of medium frequency for reducing the severity of urinary incontinence due to urgency and increasing quality of life. No current modality was superior for the treatment of urinary incontinence by urgency.
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Palavras-chave
Estimulação elétrica, Electrical stunning, Ensaio clínico controlado aleatório, Randomized controlled trial, Incontinência urinária, Urinary incontinence