ABSTRACT
Objective: Exploring the clinical efficacy of transcutaneous electrical nerve stimulation (TENS) combined with pelvic floor muscle training (PFMT) on post-radical prostatectomy urinary incontinence (PPI). Methods: Eighty patients with post-radical prostatectomy urinary incontinence, who were admitted to Tongji Hospital Affiliated with Tongji University from November 2021 to November 2022, were randomly divided into a TENS group and a PFMT group. The PFMT group received pelvic floor muscle training, while the TENS group received transcutaneous electrical nerve stimulation combined with pelvic floor muscle training. The bladder elevation, urodynamic parameters, pelvic floor muscle strength, treatment outcomes, and treatment efficacy were compared between the two groups of patients after treatment. Results: In the TENS group, the bladder elevation time was shorter and the elevation speed was higher compared with the PFMT group. The TENS group also showed higher values of Qmax, MCC, MUCP, and VLPP than the PFMT group. Furthermore, the TENS group had lower total scores of ICI-Q-SF and less urine pad usage at 72 hours compared with the PFMT group. The treatment efficacy in the TENS group was higher than that in the PFMT group. Conclusion: The combination of TENS and PFMT in PRPUI (Primary Recurrent Pelvic Organ Prolapse with Urinary Incontinence) patients can effectively build up the speed of bladder base elevation, reduce the elevation time, enhance pelvic floor muscle strength, improve patients' urodynamic parameters and urinary incontinence symptoms, and optimize treatment outcomes.
ABSTRACT
Background and Aims: Radiofrequency ablation is a commonly used treatment for paroxysmal atrial fibrillation (AF), but postoperative rehabilitation exercises are needed to reverse left ventricular structural and functional abnormalities. This meta-analysis aimed to evaluate the intervention effect of exercise training in patients with AF after radiofrequency ablation. Methods: A systematic literature search was conducted to identify articles in PubMed, MEDLINE, EMBASE, and the Cochrane Library from January 1, 2010 to December 1, 2021. The mean difference with 95% CI was pooled for continuous variables. We used Review Manager 5.3 for the standard meta-analysis. This study followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Ten randomized controlled trials (RCTs) were included, with a total of 892 patients with AF. The quality of one study was grade A, and the rest were grade B. The results of the meta-analysis showed that the improvement of 6 min walking distance (MD = 34.42, 95% CI: 3.20 to 65.63, P=0.03), peak oxygen uptake (MD = 1.96, 95% CI: 1.14 to 2.78, P < 0.001), left ventricular ejection fraction (LVEF) (MD = 0.09, 95% CI:0.01-0.17, P=0.02), resting heart rate (MD = -4.50, 95% CI: -8.85 to -0.14, P=0.04), and physical component summary (PCS) (MD = 3.00, 95% CI: 0.46 to 5.54, P=0.02) in the experimental group was significantly better than that of the control group, and the difference was statistically significant. Conclusion: Exercise training can improve the level of exercise endurance and cardiac function in patients. However, the results were limited by the quantity and quality of the studies. Large samples and high-quality studies are still needed to verify its long-term efficacy.
ABSTRACT
Neurogenic bladder is a common complication of spinal cord injury and results in urinary bladder dysfunction through lost control of micturition, or urination. Although several treatment options exist, the efficacies of many of these treatments are unknown. In particular, electroacupuncture and bladder training have had some success as individual treatments. The aim of this study was to explore effects of electroacupuncture combined with bladder training on bladder function of patients with neurogenic bladder after spinal cord injury (SCI) above the sacral segment. Forty-two patients with neurogenic bladder after SCI were evenly divided into two groups (n=21) and given only bladder function training (control group) or electroacupuncture combined with bladder function training (treatment group). Urodynamic changes, IPSS score, and therapeutic efficacy were compared between groups pre- and post-treatment. After either treatment, patients had higher bladder volume and bladder compliance, but lower residual urine volume, bladder pressure, rectal pressure, and detrusor pressure, compared to pre-treatment (P<0.05). Compared to controls, treatment group patients had significantly increased bladder volume and bladder compliance, but significantly decreased residual urine volume, bladder pressure, rectal pressure, and detrusor pressure (P<0.05). Treatment group patients had lower IPSS scores post-treatment (P<0.05) and better therapeutic efficacy (P<0.05) than control group patients. Altogether, our results suggest that electroacupuncture combined with bladder function training can clinically improve bladder function of patients with neurogenic bladder after SCI above the sacral segment.