Interferential Electrical Stimulation Research Articles

Metaboreflex Activity is Attenuated by Transcutaneous Electrical Nerve Stimulation and Interferential Electrical Stimulation in Healthy Individuals

Background: Transcutaneous electrical nervous stimulation (TENS) and interferential electrical stimulation (IES) attenuates muscle metaboreflex by sympathetic nervous modulation. Objective: We tested the hypothesis that IES may be more effective than TENS to improves blood flow which may be linked to greater of deep tissue. Methods: Eleven health subjects were randomized to TENS (80 Hz, 150μs), IES (4000 Hz, ΔAMF=25 Hz) or sham stimulation group, during 30 minutes. The acute intervention was applied on stellate ganglion region (C7-T4). Results: Were measured metaboreflex activity by calf vascular resistance (CVR) and calf blood flow (CBF) and HRV during three times: rest, exercise (static handgrip) and postexercise circulatory occlusion (PECO+ and PECO-). At the exercise peak, compared with TENS and Sham, the IES group reduced CVR (36 ± 3 vs 43 ± 3; p<0.05) and increased CBF (p<0.01). Also, IES was associated with a greater reduction on the MMA (IES: 9 ± 2, TENS: 14 ± 4, Sham: 26 ± 5 units; p<0.01). Furthermore, the IES group had a higher reduction of LF/HF ratio during PECO- and PECO+ (p<0.05). Conclusion: The IES over the stellate ganglion region seems to have superior efficacy compared with TENS to attenuate metaboreflex activation and vasodilatory responses during exercise in healthy subjects.

Comparison the effect of Swedish massage and interferential electrical stimulation on labor pain and childbirth experience in primiparous women: a randomized controlled clinical trial.

Since mothers are more inclined toward non-pharmacological labor pain management methods, this study aimed to compare the effect of interferential electrical stimulation (IES) and Swedish massage (SM) on labor pain and childbirth experience (primary outcomes) and childbirth satisfaction, duration of active phase and side effects (secondary outcomes) in primiparous women. This randomized controlled trial was performed on 90 primiparous women. Participants were randomly assigned into three groups through the block randomization method. The SM group received two massage techniques of effleurage and petrissage, on T10-L1 and S2-S4 at cervical dilatation of 4 and 8-10cm. The IES group received electrical stimulation in a similar way to SM group, with a base frequency of 4000Hz and a pulse frequency of 80-120Hz by a physiotherapist. Control group received only routine care. The mean pain was significantly lower in the SM group (adjusted mean difference (AMD) - 0.86; 95% confidence interval (95% CI) - 1.60 to - 0.11) and the IES group (AMD - 0.95; 95% CI - 1.70 to - 0.21) compared to the control group. The mean score of childbirth experience was significantly higher in the SM (MD 5.63; 95% CI 2.15-9.11) and IES (MD 3.66; 95% CI 0.18-7.14) group compared to the control group. The mean childbirth satisfaction in the SM (p = 0.003) and IES (p = 0.046) groups was significantly higher than the control group; and duration of the active phase of labor was significantly lower (p < 0.001) than the control group. No serious side effects were occurred in none of the groups. SM and IES are safe methods that can significantly reduce pain and duration of active phase and improve the experience and satisfaction of childbirth.

The role of Self-Efficacy in Chronic Pain—A Case Report Relating Motivation During The COVID-19 Pandemic and a Patient With Chronic Pain

Research ObjectivesTo analyze patient outcomes and traditional physical therapy interventions for chronic low back back, and discuss the benefits of incorporating self-efficacy techniques to improve patient independence.DesignRetrospective case report.SettingOutpatient physical therapy setting.Participants48-year-old female with complaints of chronic low back pain that has increased significantly over the last six months due to the societal consequences of COVID-19. The patient's past medical history included mild arthritis of her spine. The medications she was using for pain included Naproxen, and the patient also found relief with Salonpas pain relief patches.Interventions1. Trunk flexion AAROM, x 10 repetitions, by rolling swiss ball forward on plinth to promote a stretch of the lower back and eliminate fear of mobility.2. interferential electrical stimulation to low back to decrease pain x 10 min3. bilateral dynamic hip strengthening on hip abduction machine with 45#, 10 reps x 3 sets each4. Functional training such as proper lifting mechanics, 5 repetitions of box lifting5. physiological components aimed to improve self-efficacyMain Outcome Measures1.numerical pain rating scale2. Modified Oswestry Low Back Pain Disability QuestionnaireResultsThe patient's pain improved throughout the 6 weeks that she was seen at physical therapy. This is reflected on her scores on the NPRS. Her baseline pain rating was 9.5/10 and by 6 weeks her score decreased to 3/10. The patient also showed improvements on the Modified Oswestry Disability Index, as seen by a decrease from 42% disability to 10% disability. Improvements were seen in the patient's bed mobility, lumbar flexion AROM, bilateral hip strength, and lower abdominal strength.ConclusionsThis case is an example of someone with chronic low back pain that prior to the pandemic, had enough self efficacy to manager her condition independently. Interventions during physical therapy focused on traditional manual and therapeutic exercise principles as well as physiological components aimed to improve her self-efficacy.Author(s) DisclosuresI declare that I have no relevant or material financial interests that relate to the research described in this paper”.

Interferential Electrical Stimulation Efficacy in the Management of Lower Urinary Tract Dysfunction in Children: A Review of the Literature.

Lower urinary tract dysfunction (LUTD) is the most common problem of the referral children to the pediatric urology clinics. If this condition does not treat early in life, it will be a lifelong problem. During recent decades, electrical stimulation therapy has been expanded and extensively used for the treatment of LUTD in both adults and children. The aim of this review is to suggest clinicians an updated understanding of effects of interferential (IF) electrical stimulation therapy in management of LUTD in children. The search was performed in databases of Medline, PubMed, Google Scholar, ,and Scopus for information about IF electrical stimulation and its application using search words such as " IF electrical stimulation", "transcutaneous IF electrical stimulation" , "IF therapy " , " electrical stimulation", "voiding dysfunction" , " LUTD", " urinary incontinence" and " children". As this review focuses on the answer of this question "Does transcutaneous IF electrical stimulation has effect on management of LUTD in children?" we included the reference list of articles identified by this search strategy and selected those we judged relevant according to our keywords. Clinical trial studies that publishing in English were included. Categorical data were reported as frequencies and percentages. Eleven studies were included in this review. The success rate of IF therapy in these studies has been reported from 61% to 90% of children with LUTD and urinary incontinence. IF electrical stimulation is an effective, safe and reproducible option to manage LUTD and urinary incontinence in children.

Effect of interferential Electrical Stimulation on pain perception and disability level on Interstitial Cystitis: a randomized controlled trial

Background. Interstitial cystitis is a range of urological manifestations that are characterized by bladder, pelvic and urethral pain, just as irritative voiding side effects. It is characterized by the International Continence Society as the protest of suprapubic pain, identified with bladder filling combined by different manifestations, for example, expanded day time and evening time recurrence, without demonstrated urinary contamination or different evident pathology of the lower urinary tract. Objective. To investigate the effect of interferential electrical stimulation on pain perception and disability level on interstitial cystitis. Participants and methods. A total of 40 volunteering women diagnosed with interstitial cystitis. Their ages were ranged between 25 to 40 years old and their body mass index was &gt; 30 kg/m2. Participants were randomly assigned to two equally numbered groups; group (A) receiving interferential current at the lower abdomen, in addition to a routine medical intervention, or group (B) receiving solely routine medical intervention for 8 successive weeks. Participants were assessed for pain using visual analog scale (VAS), related disability index using levels using O’Leary–Sant Symptom Index or Interstitial Cystitis Index (ICSI), and blood cortisol concentration. Measurements were taken before and after eight weeks of intervention. Results. The analysis of the results revealed a significant reduction in VAS score (P &lt; 0.0001), ICSI scores (P &lt; 0.0001), and the plasma cortisol concentration (P &lt; 0.0001) in the participants of group (A) at the end of the treatment, compared to group (B). Conclusion. These results concluded that adding IC therapy to routine medical intervention had an excellent effect on the management of interstitial cystitis associated signs and symptoms particularly pain, plasma cortisol levels, related disabilities.

Management of Bladder Bowel Dysfunction in Children by Pelvic Floor Interferential Electrical Stimulation and Muscle Exercises: A Randomized Clinical Trial

ObjectiveTo assess efficacy of combined pelvic floor interferential (IF) electrical stimulation and muscle exercises on bladder bowel dysfunction (BBD) in children. Materials and methodsA total of 34 children with BBD (6 boys, 28 girls; mean age 7.4 ± 2.2) were included in this study. Children were evaluated with kidney and bladder ultrasounds, uroflowmetry + electromyography (EMG), and a complete voiding and bowel habit diary before treatment. Exclusion criteria were neuropathic disease, anatomical defects, and mental retardation. Participants were randomly allocated into 2 treatment groups including group A (n = 17) who underwent IF electrical stimulation in addition to pelvic floor muscle (PFM) exercises and group B (n = 17) who received PFM exercises alone. All children were re-evaluated by kidney and bladder ultrasounds, uroflowmetry + EMG and a voiding and bowel habit diary at the end of treatment sessions and 6 months later. ResultsConstipation improved in 14 of 17(82%) and 8 of 17(47%) children in group A and B respectively at the end of treatment sessions (P = .03). Daytime incontinence improved in all children in group A and 2 of 8(25%) children in group B after the treatment (P = .007). Urinary tract infection improved in 8 of 10(80%) and 5 of 13(38.4%) children in group A and B respectively, 6 months after the treatment (P = .02). No significant difference was observed in uroflowmetry measures between 2 groups after the treatment. ConclusionCombination of IF electrical stimulation and PFM exercises is an effective and safe modality for treatment of BBD in children.

Interferential Electrical Stimulation Versus Pulsed Electro-Magnetic Field in Management of Intermittent Claudication

Background: Intermittent claudication is the occurrence of leg pain, aching, cramping, or fatigue triggered by walking and relieved by rest. It's a chronic disabling condition and the first symptom of peripheral arterial disease (PAD). Objective: This study was designed to compare between the therapeutic efficacy of Interferential electrical stimulation and pulsed electromagnetic field (PEMF) in management of intermittent claudication (IC). Subjects and methods: Forty five patients suffering from intermittent claudication due to atherosclerosis (Fontain stage II PAD) and randomly were assigned into three equal groups. Group “A” included 15 patients received 30 min of pulsed electromagnetic field in addition to heel raise exercise and calf stretch exercise and their medical treatment, group “B” included 15 patients received 20 min of interferential electrical stimulation in addition to heel raise exercise and calf stretch exercise and group “C” (control group) that included 15 patients received their medical treatment only. Ankle brachial pressure index, graded treadmill exercise testing to determine absolute claudication distance (ACD), Peak walking time (PWT) and walking impairment questionnaire (distance score, speed score, symptoms impairment score) were recorded pre and post the two months period for all groups. Results: All measured parameters were significantly improved in all groups with the greatest improvement was in group (A) and the least improvement was in group (C) except for ankle brachial index that was changed significantly in group (A) only. Conclusion: PEMF could be an effective vascular rehabilitation modality for improving walking efficiency and functional capacity in patients with intermittent claudication. It significantly increases the blood flow in peripheral arteries and so on can delay the complications of intermittent claudication.

Electrical stimulation therapy for chronic constipation: a systematic review and meta-analysis

IntroductionTreatment of chronic constipation often is challenging, and non-traditional treatment methods, including nonpharmacological methods, may be attempted. Electrical stimulation therapy (EST) has been tried in many small and uncontrolled series. Although most results have been encouraging, validity of the method has not been established.Material and methodsFive articles, concerning 338 patients (average age: 40.8–63.6 years) with constipation, were included in the study. Electroacupuncture or transcutaneous interferential electrical stimulation was the modality used. The causes of the constipation were stroke, slow transit, functional, opioid use, or unknown etiology. The primary and secondary outcomes were response rate and degree of constipation, respectively. Adverse events were also assessed.ResultsThe results of the meta-analysis yielded a significant improvement in treatment response for EST compared with control treatment (medications or sham control), with the odds ratio 4.263 (95% CI: 1.456–12.484, p = 0.008). A significant reduction in degree of constipation also was found, with the pooled estimate of standardized difference in mean change 1.039 (95% CI: 0.315–1.763, p = 0.005). The average percentage of adverse events associated with EST was &lt; 5%.ConclusionsThe EST with electroacupuncture or transcutaneous interferential electrical stimulation for the treatment of constipation due to various causes is effective and reasonably safe. However, further detailed studies using these methods are needed.

Randomised clinical trial: transabdominal interferential electrical stimulation vs sham stimulation in women with functional constipation.

Managing chronic constipation is challenging as patients frequently remain dissatisfied with laxative treatments. Novel studies using transabdominal electrical interferential therapy in children have shown benefit but there are inadequate adult studies. To examine the effects of transabdominal interferential stimulation on bowel symptoms and quality of life in women with refractory constipation. In a single-blind, randomised, sham-controlled pilot study, women aged ≥18years with refractory constipation were randomised to receive interferential stimulation (with crossing of electric currents) or a novel sham stimulation (with no crossing of currents) for 1hour a day for 6weeks. Primary outcome was the number of patients with ≥3 spontaneous bowel movements/week. Secondary endpoints included change in PAC-SYM (Patient Assessment of Constipation-SYMptoms), PAC-QOL (Patient Assessment of Constipation-Quality of Life) and an overall symptom severity score (measured at baseline, mid time point of stimulation, end of treatment and 3months after cessation of treatment). Interferential therapy (n=17) met the primary outcome in 9(53%) compared with 2(12%) with sham therapy (n=16) (P=0.02). Interferential therapy resulted in reductions in PAC-SYM (P=0.03) and overall symptom scores (P=0.05). Laxative use more than halved in 66% with interferential therapy compared with 14% with sham therapy (P=0.01). Significant improvements in symptom outcomes were maintained at 3months. There were no treatment-related adverse effects. Transabdominal interferential electrical stimulation is effective in reducing constipation in adult women. Three months after therapy, response is maintained and quality of life improved. Not allowing currents to cross intra-abdominally was an effective placebo. (Australianclinicaltrials.gov.au ACTRN12614000736640).

A comparative study of transcutaneous interferential electrical stimulation and transcutaneous electrical nerve stimulation on children with primary nocturnal enuresis: a randomized clinical trial.

Nocturnal enuresis is an infrequent uncontrolled voiding during sleep in a child aged 5years or more without any congenital or acquired disorders of the central nervous system. To compareimmediate and short-term effectsof interferential currents (IFC) and transcutaneous electrical nerve stimulation (TENS) in the treatment of children with primary nocturnal enuresis (PNE) in numbers of wet nights and quality of life (QoL). 52 children aged 7-14 (10.6 ± 1.9) having PNE, were assigned randomly into two groups (26 children for each group). Both IFC and TENS groups continued treatment session for 20min, 3 sessions per week for 6weeks. The outcome measures were the number of wet nights, and QoL through pediatric incontinence questionnaire (PinQ).The measurements were evaluated before treatment (Pre-), after the last session (Post-1), and 6months later (Post-2). By comparing the Pre- and Post-1 mean values, the number of wet nights, reduced significantly (P < 0.05) in both groups, in favor of IFC group. Post-1 showed many children with full and good responses and few numbers with partial or no responses to IFC than TENS. Post-1 revealed that PinQ was significantly reduced in both groups in favor of the IFC group (P < 0.05). The values were slightly improved in both groups in Post-2, they were significantly different between Pre- and post-measurements in each group (P < 0.05). Comparison between both groups showed significant differences in the mean values between Post-1 and Post-2 in favor of IFC group (P < 0.05). IFC and TENS had immediate and short-termimprovements in children with PNE by reducing numbers of wet nights and enhancing QoL in favor of the IFC group.

Impact of transcutaneous interferential electrical stimulation for management of primary bladder neck dysfunction in children

Several studies have revealed that electrical stimulation is an effective modality for treatment of lower urinary tract (LUT) dysfunction via raising the capacity or compliance of the bladder or maybe by pelvic floor relaxation and reducing detrusor pressure as well. This study aimed to assess the efficacy of transcutaneous interferential (IF) electrical stimulation on LUT symptoms as well as urine flow parameters in children with primary bladder neck dysfunction (PBND). We reviewed the charts of all children with persistent LUT symptoms who underwent IF electrical stimulation between 2010 and 2017. Twenty-three neurologically and anatomically normal children (mean age: 7.7years, range: 5-13) with LUT symptoms were included in this study. Children had different LUT symptoms such as hesitancy, straining, urinary incontinence and constipation with no sufficient response to medical treatment (α -blocker) for at least 6months. IF electrical stimulation was performed for 15 sessions, two times per week. All children were symptomatic and had abnormal urine flow pattern with an electromyographic (EMG) lag time of more than 6s on uroflowmetry with EMG. A voiding chart, uroflowmetry with EMG and kidney and bladder ultrasounds were performed before and after the treatment for all children. Maximum and average urine flow rates, EMG lag time and postvoid residual volume were analyzed. In addition, alpha blocker therapy was continued during IF therapy. Mean maximum and average urine flow rates improved from 14.1 to 7.6-19.7ml/s and 9.5ml/s, respectively, while mean EMG lag time decreased from 11.7 to 5.2s after the treatment (all P<0.05). Also postvoid residual volume decreased significantly from 35.6 to 7.6mlat the end of treatment courses. Pelvic floor EMG lag time, a documented parameter on uroflowmetry with EMG, defined as the time from the start of pelvic floor relaxation during a volitional voiding effort (the first stage of normal voiding) to the start of urine flow. Results showed that IF therapy decreased pelvic floor EMG lag time in children with PBND. In addition, increase in mean maximum and average urine flow rates in our patients indicated that pelvic IF therapy and behavioral modification improved voiding dysfunction in most of the patients and probably decreased bladder neck activity during voiding. Future studies with larger sample size are needed to support this finding. IF therapy appears safe, effective and reproducible in improvement of PBND in children.

Interferential electrical stimulation for improved bladder management following spinal cord injury.

Patients with spinal cord injury (SCI) with neurogenic bladder (NB) represent a major medical problem, which initiated the search for a non-invasive and effective treatment that is easy to apply and without side effects. A study was performed using interferential medium frequency current electrical stimulation (IMFC ES) on 332 patients shortly after SCI diagnosed with NB dysfunction. All subjects received standard care and patients of the experimental group additionally received IMFC ES. Urinary management results included volitional control of voiding, intermittent catheterization, post-voidance residuum (PVR) quantity and quantity of urine lost (LOSS). Results were assessed based on the American spinal cord injury association impairment scale (AIS). The IMFC ES included two channels of medium frequency stimulation that were marginally different. Within the body, a low frequency field was generated through the interaction of the medium frequencies, which stimulated the urinary structures. In the IMFC ES group, interference stimulation was applied for 10 min with frequencies cycling from 0-100 Hz and back in 10 sec intervals. The strength of the low frequency stimulation, achieved by the interference of the two medium-frequency fields, was adjusted to the patients' vibration sensation. The intensities triggering vibration sensation were between 20-80 mA for patients with AIS levels B, C and D. For patients with AIS level A intensities <20 mA were used for therapeutic effects without causing skin injuries. Safety of IMFC ES was based on occurrence of adverse events of which none were recorded in the experimental group. IMFC ES was effective in patients with AIS levels B and C, significantly decreasing PVR and LOSS compared with patients receiving standard care No significant improvements in urinary management were observed following IMFC ES treatment of patients with AIS level A. Patients with SCI and NB classed as AIS levels B and C that exhibit preserved sensitivity were the best beneficiaries of IMFC ES therapy.

Home-Based Transabdominal Interferential Electrical Stimulation for Six Months Improves Paediatric Slow Transit Constipation (STC)

Transcutaneous electrical stimulation (TES) for one to two months has produced some improvement in treatment-resistant slow-transit constipation (STC) in children. Optimal parameters for treatment are not known. It is possible that more improvement would occur with stimulation for longer. This study examined the effectiveness of stimulation for six months. Children with STC confirmed by nuclear transit study (NTS) were enrolled prospectively. All had chronic constipation for greater than two years and had failed medical treatment. TES was performed for one hour/day for six months using the INF 4160 (Fuji Dynamics) portable stimulator and 4 cm × 4 cm electrodes near the belly button and on the back. Families kept bowel diaries and completed PEDSQLCore QOL (4.0) questionnaires before and at end of treatment. Sixty-two children (34 females; seven years, 2-16 year) with STC were studied. Defecation frequency increased in 57/62 (91%, mean ± SEM pre- 1.49 ± 0.20 vs. post- 3.25 ± 0.25 defecation/week, p < 0.0001) with the number with ≥3BA increasing from 6 to 37 (10-59%). Soiling frequency decreased from 4.8 to 1.1 days/week (p <0.001). Abdominal pain decreased from 1.7 to 0.3 days/week (<0.0001), and spontaneous urge to defecate improved. Quality of life (p < 0.01), mean transit index and gastric emptying on NTS improved (p < 0.005). Treatment-resistant STC responds to TES using interferential current across the abdomen when given daily for many months. Battery operated stimulators allowed stimulation at home for an hour each day. Stimulation for six months produced clinically significant improvement in defecation frequency, soiling, abdominal pain, urge to defecate, and quality of life in half of these chronic patients.

Pelvic floor electrical stimulation and muscles training: a combined rehabilitative approach for management of non-neuropathic urinary incontinence in children

PurposeTo assess the efficacy of combined transcutaneous interferential (IF) electrical stimulation and pelvic floor muscle training through biofeedback on non-neuropathic urinary incontinence in children. MethodsThis prospective study comprised of 46 anatomically and neurologically normal children (9 boys, 37 girls; mean age of 8.4 ± 2.2 years old) with non-neuropathic urinary incontinence. All children were evaluated by kidney and bladder ultrasounds, uroflowmetry with electromyography (EMG), a complete voiding diary and a dysfunctional voiding scoring questionnaire at the baseline. Children were randomly allocated into two treatment groups including group A (n = 23) who underwent biofeedback therapy in addition to IF electrical stimulation and group B (n = 23) who received only biofeedback therapy. Re-evaluation was performed 6 months and one year after completion of the treatment sessions. ResultsImprovement of non-neuropathic urinary incontinence was significantly higher in group A in comparison to group B at two follow ups (P < 0.05). Daytime incontinence was improved in 19/23(82%) and 13/23(56.5%) of children in groups A and B respectively after the treatment (P < 0.01). There was no significant difference in uroflowmetry measures between two groups after the treatment. ConclusionsCombination of biofeedback therapy and transcutaneous IF electrical stimulation is a potential effective modality in treating non-neuropathic urinary incontinence in children. Level of EvidenceType of study: Treatment study.Level I: Randomized controlled trials with adequate statistical power to detect differences (narrow confidence intervals) and follow up >80%.

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

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.

Efficacy of interferential therapy versus transcutaneous electrical nerve stimulation to reduce pain in patients with diabetic neuropathy

Efficacy of interferential therapy versus transcutaneous electrical nerve stimulation to reduce pain in patients with diabetic neuropathy

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

Effects of Interferential Electrical Stimulation Plus Pelvic Floor Muscles Exercises on Functional Constipation in Children: A Randomized Clinical Trial.

Functional constipation is a common condition in children. We assessed the effectiveness of combined interferential (IF) electrical stimulation and pelvic floor muscle (PFM) exercises on functional constipation in children. We conducted a single-center, double-blind randomized clinical trial study during 2014-2017 in Tehran, Iran. Ninety children, aged 5-13 years, who fulfilled Rome III criteria were enrolled and randomly assigned into two treatment groups. Case group (n=45) underwent IF electrical stimulation and PFM exercises, whereas the control group (n=45) received PFM exercises plus sham stimulation. A complete bowel habit diary (with concerning data on the frequency of defecation per week, stool form, and the number of fecal soiling episodes), a constipation score questionnaire, and a visual pain score were recorded before, after the treatment and 6 months later for all participants. In addition, children in both groups were assessed with a constipation-related quality-of-life questionnaire before, after the end of treatment sessions, and 6 months after the treatment. Treatment success was achieved for 88.4% of children in the case group compared with 43.2% of children in the control group after the treatment (P<0.003). The median constipation score was reduced in both groups, with the cases having significantly lower scores after the treatment (4 vs. 8, P<0.000). Stool form normalized in 75.6% of the cases and 45.5% of the controls after the treatment (P<0.01). Our results showed that using IF electrical stimulation as an adjuvant therapy to the medical and rehabilitation programs significantly boosts the effects of treatment among these patients.

Editorial Comment

No AccessJournal of UrologyPediatric Urology1 Sep 2017Editorial Comment Soledad Celis and Pedro-José Lopez Soledad CelisSoledad Celis More articles by this author and Pedro-José LopezPedro-José Lopez More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.04.105AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Editorial Comment." The Journal of Urology, 198(3), pp. 692–693 References 1 : Efficacy of transcutaneous interferential electrical stimulation in treatment of children with primary nocturnal enuresis: a randomized clinical trial. Pediatr Nephrol2015; 30: 1139. Google Scholar 2 World Bedwetting Day home page. Available at http://www.worldbedwettingday.com/. Google Scholar © 2017 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 198Issue 3September 2017Page: 692-693 Advertisement Copyright & Permissions© 2017 by American Urological Association Education and Research, Inc.MetricsAuthor Information Soledad Celis More articles by this author Pedro-José Lopez More articles by this author Expand All Advertisement PDF downloadLoading ...

Are Interferential Electrical Stimulation and Diaphragmatic Breathing Exercises Beneficial in Children With Bladder and Bowel Dysfunction?

To evaluate the effects of interferential current (IC) stimulation and diaphragmatic breathing exercises (DBEs) in children with bladder and bowel dysfunction. Seventy-nine children with dysfunctional voiding and chronic constipation who were failures of primary care interventions were included in the prospective clinical study. All the children were checked for their medical history regarding lower urinary tract symptoms and bowel habits. Physical examination, including abdominal and anorectal digital examination, was performed. Children kept a bladder and bowel diary, and underwent urinalyses and urine culture, ultrasound examination of bladder and kidneys, and uroflowmetry with pelvic floor electromyography. Eligible children were divided into 3 groups (A, B, and C). All groups were assigned education and behavioral modifications. Additionally, group A underwent DBEs and IC stimulation, whereas group B received only DBEs. The treatment was conducted for 2 weeks in the clinic in all 3 groups,. The behavioral modifications and DBEs were continued at home for 1 month. Clinical manifestations, uroflowmetry parameters, and postvoided residual urine were analyzed before and after 6 weeks of therapy. After the treatment, significant improvement in defecation frequency and fecal incontinence was noticed only in group A (P < .001 and P < .05, respectively). These children demonstrated significant improvement in lower urinary tract symptoms and postvoided residual urine (P < .001 and P < .05, respectively). Bell-shaped uroflowmetry curve was observed in 73.3% of group A patients (P < .001). IC stimulation and DBEs are beneficial in chronically constipated dysfunctional voiders. Further trials are needed to define the long-term effects of this program.