ABSTRACT
Bladder dysfunction, particularly neurogenic detrusor overactivity (DO), poses a substantial challenge in multiple sclerosis (MS) patients, detrimentally impacting their quality of life (QoL). Conventional therapies often fall short, necessitating alternative approaches like posterior tibial nerve stimulation (PTNS) for effective management. This narrative review critically examines the application of PTNS in treating DO among MS patients, aiming to provide a comprehensive synthesis of its efficacy, underlying mechanisms, and clinical outcomes. By evaluating a spectrum of studies, including randomized controlled trials and long-term follow-up research, the review elucidates PTNS's role in enhancing bladder control and ameliorating symptoms of urgency and incontinence, thereby improving patient well-being. Despite its potential, the review acknowledges the limited scope of existing research specific to MS-induced neurogenic DO and calls for further investigation to optimize PTNS protocols and understand its long-term benefits. Highlighting PTNS's minimal invasiveness and favorable safety profile, the review advocates for its consideration as a viable third-line treatment option in MS-related bladder dysfunction management. Through this analysis, the review contributes to the broader narrative of seeking effective, patient-centered therapeutic strategies for MS-related complications, underscoring the importance of personalized care in improving patient outcomes.
ABSTRACT
This study investigates the impact of pelvic floor muscle training (PFMT) on sexual function and distress in women with multiple sclerosis (MS), a prevalent chronic nervous system disorder associated with sexual dysfunction. This study's primary aim was to assess the effectiveness of PFMT at improving sexual function and alleviating sexual distress in this population. In a randomised controlled trial, 82 women with MS were divided into two groups: Group A (41 women) underwent 12 weeks of PFMT, while Group B (41 women) served as a control group with no intervention. Both groups were assessed at the beginning and end of this study using the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R). Statistical analysis, including Chi-square tests, was employed to compare the outcomes between the two groups, with a p-value of less than 0.05 considered significant. The results revealed no significant differences in baseline sexual function and distress between the groups. However, at the conclusion of the 12-week period, Group A exhibited statistically significant improvements in nearly all domains of FSFI and FSDS-R compared to Group B, except in the pain domain. This study concludes that PFMT can effectively enhance sexual function and reduce sexual distress in women suffering from MS. These findings underscore the potential of PFMT as a therapeutic intervention in managing sexual dysfunction associated with MS.
ABSTRACT
ABSTRACT Objective: Mobile health (mHealth) applications are scarce for children and adolescents with chronic pulmonary diseases (CPDs). This study aimed to map and describe the contents of the mHealth apps available for use in children and adolescents with CPDs. Methods: We performed a systematic mapping review of published scientific literature in PubMed, Scopus, and Cochrane Library by February of 2023, using relevant keywords. Inclusion criteria were as follows: children aged < 18 years with CPDs; and studies published in English on mHealth apps. Results: A total number of 353 studies were found, 9 of which met the inclusion criteria. These studies described seven mHealth apps for Android and iOS, designed either for asthma (n = 5) or for cystic fibrosis (n = 2). Five content areas were identified: education/information; pharmacological treatment; emergency; support; and non-pharmacological treatment. The studies (4, 2, and 3, respectively) showed consistent findings using qualitative, quantitative, and mixed methodologies. Conclusions: This mapping review provided a guided selection of the most appropriate mHealth apps for use in children and adolescents with CPDs based on the needs of each target population. However, these mHealth apps have limited capabilities to reinforce disease self-management and provide information related to treatment compliance.
RESUMO Objetivo: Aplicativos de saúde móvel (mHealth, do inglês mobile health) para crianças e adolescentes com doenças pulmonares crônicas (DPC) são escassos. Este estudo teve como objetivo mapear e descrever o conteúdo dos aplicativos de mHealth disponíveis para uso em crianças e adolescentes com DPC. Métodos: Realizamos uma revisão sistemática de mapeamento da literatura científica publicada nos bancos de dados PubMed, Scopus e Cochrane Library até fevereiro de 2023, utilizando descritores relevantes. Os critérios de inclusão foram os seguintes: crianças menores de 18 anos com DPC e estudos publicados em inglês sobre aplicativos de mHealth. Resultados: Foram encontrados 353 estudos, dos quais 9 atenderam aos critérios de inclusão. Esses estudos descreveram sete aplicativos de mHealth para Android e iOS projetados para asma (n = 5) ou para fibrose cística (n = 2). Foram identificadas cinco áreas de conteúdo: educação/informação, tratamento farmacológico, emergência, suporte e tratamento não farmacológico. Os estudos (4, 2 e 3, respectivamente) apresentaram achados consistentes utilizando metodologias qualitativas, quantitativas e mistas. Conclusões: Esta revisão de mapeamento forneceu uma seleção guiada dos aplicativos de mHealth mais adequados para uso em crianças e adolescentes com DPC com base nas necessidades de cada população-alvo. No entanto, esses aplicativos de mHealth têm capacidades limitadas para reforçar a autogestão da doença e fornecer informações relacionadas à adesão ao tratamento.