ABSTRACT
AIMS: This study aims to investigate the efficacy of transcutaneous tibial nerve home stimulation for overactive bladder (OAB) in women with Parkinson's disease (PD). METHODS: The current study is a prospective, randomized, double-blind, sham-controlled trial. Home intervention was carried out and assessments were conducted at a tertiary hospital in South Brazil. Women with PD and OAB symptoms were included in the study. Patients were randomly divided into two groups: (1) stimulation and (2) sham. Both groups underwent intervention at home for 12 weeks. Patients were evaluated at baseline and at 12 weeks (end of intervention), 30- and 90-day follow-up. The primary outcome was the mean reduction in the number of urgency incontinence episodes, and secondary outcomes included daytime and nighttime urinary frequency, urinary urgency episodes, use of pad (reported in a 24-h bladder diary), OAB-V8 and King's Health Questionnaire scores, and maintenance of symptom relief after discontinuation of the intervention. RESULTS: In total, 30 consecutive patients completed the study (15/group). The stimulation group showed a reduction in nighttime urinary frequency (0.9 ± 0.6), urinary urgency (1.0 ± 1.2), urgency incontinence episodes (0.5 ± 0.6), use of pads (1.3 ± 1.2), and OAB-V8 (1.3 ± 1.2) and King's Health Questionnaire scores. In a 30-day and 90-day follow-up, 8 (53.3%) and 5 (33.3%) stimulation patients, respectively, reported full maintenance of symptom relief after discontinuation of the intervention. Stimulation patients presented a statistically significant improvement of symptoms as compared with sham patients (p = .001). CONCLUSIONS: Transcutaneous tibial nerve home stimulation can be used in clinical practice as an effective nonpharmacological resource for the reduction of OAB symptoms in women with PD, and the resulting relief seems to persist in the follow-up (30 and 90 days).
Subject(s)
Parkinson Disease/complications , Tibial Nerve/surgery , Transcutaneous Electric Nerve Stimulation/methods , Urinary Bladder, Overactive/therapy , Aged , Double-Blind Method , Female , Humans , Male , Middle Aged , Prospective Studies , Treatment OutcomeABSTRACT
Although biofeedback has been used as a first-line therapy for fecal incontinence, it is known to be time consuming and demands attendance to a hospital during the whole period of treatment. In this study, we describe a new biofeedback device specifically developed for home treatment of fecal incontinence, which consists of a microprocessor controlled unit able to register and store the anal pressure waves corresponding to exercises performed by patients at home. In order to test the new device, a pilot study including ten patients with fecal incontinence was conducted. Evaluation of patients before and after the biofeedback training showed significant improvement in manometric and clinical parameters of anal continence. The new method may improve compliance of patients with the training program and reduce their need to be supervised during the treatment. It might represent a new alternative for the treatment of fecal incontinence.
Subject(s)
Biofeedback, Psychology/methods , Fecal Incontinence/therapy , Aged , Anal Canal/physiopathology , Fecal Incontinence/physiopathology , Female , Humans , Middle Aged , Pelvic Floor/physiopathology , Pilot Projects , Treatment OutcomeABSTRACT
Objetivo: Descrever a avaliação em cirurgias do ouvido médio em seres humanos, do microcautério otológico Lavinsky/HCPA...
Subject(s)
Humans , Otologic Surgical Procedures/instrumentation , Cautery/instrumentation , Cautery/methods , Stapes Surgery , TympanoplastyABSTRACT
O equipamento de Biofeedback eletromiográfico utiliza circuitos eletrônicos para detetar e amplificar sinais biológicos associados às atividades musculares, fornecendo informações precisas sobre o estado de contração muscular do paciente e possibilitando que ele interaja no sentido de modificá-lo.
Abstract : The electromyographic Biofeedback detects and amplifies biological signals related to muscular activities using electronic circuits. It provides some information about the muscular aotivity of the patients helping them to modify wrong habits
Subject(s)
Electromyography/instrumentation , Muscle Contraction/radiation effects , Fractures, Stress , Cerebrovascular Disorders/therapy , Muscle Fatigue , Feedback , Electric Stimulation TherapyABSTRACT
O sistema proposto visa avaliar, qualitativa e quantitativamente, o comportamento de diferentes técnicas de síntese pós-osteotomia em metatarsos, mediante aplicação de esforços conhecidos em suas extremidades.
The equipment measures the deviation of the first metatarsal head as a result of forces applied through its plantar surface. Load displacement curves were obtained and the stiffness of severa! metatarsal osteotomy j!xation techniques were then compared
Subject(s)
Osteotomy , Metatarsal Bones , Equipment and Supplies , Hallux Valgus/surgery , Physical Exertion , Bone Wires , Bone Screws , Bone Plates , Exercise Test/methodsABSTRACT
Objetivos: Avaliaçäo da técnica FES em pacientes com patologias neurológicas diversas, utilizando equipamentos desenvolvidos pela Engenharia Biomédica do Hospital de Clínicas de Porto Alegre. Os objetivos principais deste trabalho säo: reduçäo da espasticidade muscular, fortalecimento muscular e melhora no padräo de marcha. Material: FES-II portátil, 2 canais, Engenharia Biomédica - HCPA; FES-II clínico, 2 canais, Engenharia Biomédica - HCPA. Estes equipamentos FES possuem as seguintes características principais: Canais: 2 canais isolados; Amplitude da corrente de saída: 0 a 80 mA; Largura dos pulsos: 100 a 700µs; Freqüência dos pulsos: 10 a 60 Hz; Trem de pulsos (Tempos de ataque, sustentaçäo, descida e repouso): ajustáveis; Controle Automático e Manual; Marcha automaticamente assistida (utilizando duas palmilhas especialmente desenvolvidas). Métodos: Metodologia da Escola de Lubljana. Sessöes periódicas de 10 minutos cada, aplicadas a pacientes previamente selecionados. Os resultados foram avaliados pela análise dos padröes de marcha e o exame clínico dos músculos estimulados.
