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Urinary Incontinence, UrgeTibialTNSNCT05590481

Effect of Tibial Transcutaneous Electrostimulation in Women with Urgency Urinary Incontinence

A study testing TIBIAL TRANSCUTANEOUS ELECTROSTIMULATION and behavioral therapy protocol in people with Urinary Incontinence, Urge, run by Instituto Materno Infantil Prof. Fernando Figueira at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Urge urinary incontinence (UUI) is associated with nocturia, a common cause of sleep disorders, also related to levels of anxiety and depression. Studies demonstrate improvement in the clinical parameters of women with UUI after treatment with transcutaneous tibial nerve stimulation (TTNS). Read more about this study

Who is it for?
Ages 18 years and older, women only
Conditions the study is for
Urinary Incontinence, Urge
What is being tested?
TIBIAL TRANSCUTANEOUS ELECTROSTIMULATION and behavioral therapy protocol
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
103 participants
Where
1 siteBrazil
Study dates
23 Jan 2023to 30 Dec 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • Women only
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Female sex;
  • Age from 18 years old;
  • Diagnosis of urgency urinary incontinence or mixed urinary incontinence
  • Score greater than or equal to 8 on the Hyperactive Bladder - Validated 8 Question Awareness Tool (OAB-V8)

Who cannot join

  • -Active urinary infection in the last four weeks;
  • Alcoholism, smoking or drug addiction;
  • Lesions and alteration of skin sensitivity in the place where electrotherapy will be applied;
  • Drug and/or physiotherapeutic treatment for urgency urinary incontinence;
  • Use of sleep-inducing medication,
  • Any neurological disease (multiple sclerosis, Alzheimer's disease, stroke and Parkinson's disease);
Show all 10Show fewer
  • Use of anticholinergic drugs, calcium antagonists, b-antagonists and dopamine antagonists;
  • Presence of pelvic organ prolapse (POP), measured by a score greater than III by the POP-Q system;
  • Any comprehension difficulty or cognitive deficit that makes it impossible to carry out the research;
  • Gestational or puerperal period.

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Instituto de medicina integral fernando figueira

    Recife, Pernambuco, 50070-902

Other trials in Brazil

About this study

Official title: Effect of Tibial Transcutaneous Electrostimulation in Women with Urgency Urinary Incontinence Compared to a Sham Group: Randomized Clinical Trial

Urge urinary incontinence (UUI) is associated with nocturia, a common cause of sleep disorders, also related to levels of anxiety and depression. Studies demonstrate improvement in the clinical parameters of women with UUI after treatment with transcutaneous tibial nerve stimulation (TTNS). However, there are few data available on the association of urinary symptoms in women with UUI with sedentary behavior (SB), physical activity level (PAL) and sleep quality (SQ). Our study has the objective of evaluating the impact of TTNS on urinary symptoms, anxiety level, life quality(LQ), sleep parameters, PAL and SB in women with UUI.

Read the detailed description

A randomized clinical trial, sham-controlled, comparing behavioral therapy and TTNS (intervention) to the use of behavioral therapy alone. It will include women with 18 years or more, diagnosed with UUI or mixed IU attested by the Questionnaire Overactive Bladder Validated 8 (OAB-V8).

Women with active urinary tract infection in the last four weeks, alcoholics, smokers or drug addicts, with lesions and alteration of skin sensitivity in the place where electrotherapy will be applied, in drug and/or physiotherapeutic treatment for UUI or current OAB, using sleep-inducing medication, with any neurological disease, using anticholinergic drugs, calcium antagonists, antagonists and dopamine antagonists, with presence of pelvic organ prolapse, during pregnancy or puerperal or with any difficulty in understanding or cognitive deficit that makes it impossible to carry out the research will be excluded.

Study variables are behavioral therapy, bilateral transcutaneous tibial nerve stimulation, type of UI, PAL, excessive daytime sleepiness, generic and specific LQ, SQ, UI severity, anxiety level, urinary frequency, nocturia and bladder capacity.

Sample size was calculated, adopting a two-tailed test with the following parameters: α = 0.05, β = 0.20 and statistical power of 80% and 102 women will be included.

The study will be carried out in two physiotherapy clinics in Recife, from September 2022 to June 2023, both groups will undergo a behavioral therapy protocol, (bladder training, pelvic floor muscle training and modification of liquid intake). Patients will be submitted to biphasic current and surface electrodes during 12 treatment sessions, twice a week, on non-consecutive days, with a electrical stimulation device (Quark, Brazil). The following parameters will be used for TTNS: frequency 10Hz (dez Hertz), pulse duration 200 μs (microseconds), for 30 minutes. In the experimental group, the electrodes will be positioned on the medial malleolus of both legs), in order to stimulate the tibial nerve path. In the Sham group, the electrodes will be placed on both legs, centered in the middle of the thigh, where there is no stimulus for the tibial or sacral nerve, for 30 minutes.

The project was approved by the Research Ethics Committee of Professor Fernando Figueira Institute of Integral Medicine.

Being tested
TIBIAL TRANSCUTANEOUS ELECTROSTIMULATION, behavioral therapy protocol
Keywords
urinary incontinence, Sleep, nocturia, sedentary behavior, anxiety, quality of life
Medical subject headings
Urinary Incontinence, Urge, Urinary Incontinence, Nocturia, Sedentary Behavior, Anxiety Disorders

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • TIBIAL TRANSCUTANEOUS ELECTROSTIMULATIONDevice

    The electrodes will be surface (silicone rubber and carbonate), brand Quark®, with dimensions of 5 cm by 3 cm, coupled with conductive gel and fixed to the volunteer's skin with micropore tape. For the placement of the electrodes, the volunteer will be positioned in the horizontal supine position on the stretcher, with the knee in semiflexion and the head supported on a pillow. The electrodes will be positioned one immediately posterior to the medial malleolus of the ankle and the other approximately 10 cm above it, both fixed with micropore tape, on both legs of the patient. To ensure that the electrodes stimulate the tibial nerve, a transcutaneous electrical nerve stimulation (TENS) current with a frequency of 1 Hz will first be applied, with a gradual increase in intensity, to verify a rhythmic movement of flexion of the hallux. The following parameters will be used for TTNS: frequency 10Hz (Hertz), pulse duration 200 μs (microseconds), for 30 minutes.

  • behavioral therapy protocolBehavioural

    submitted to a behavioral therapy protocol, which involves bladder training, pelvic floor muscle training and modification of liquid intake. The orientation will be based on the initial evaluation of the patient, in which the responsible researcher will give verbal orientations and deliver booklets on the pathology, behavioral therapy and sleep hygiene.

Study groups in NCT05590481
Study groupRoleWhat they receive
EG (experimental group): TIBIAL TRANSCUTANEOUS ELECTROSTIMULATION + Behavioral TherapyExperimentalEG (experimental group): submitted to a behavioral therapy protocol, which involves bladder training, pelvic floor muscle training and modification of liquid intake. The orientation will be based on the initial evaluation of the patient, in which the responsible researcher will give verbal orientations and deliver booklets on the pathology, behavioral therapy and sleep hygiene. In addition, patients will be submitted to biphasic current and surface electrodes during 12 treatment sessions, twice a week, on non-consecutive days, with a DUALPEX 961s electrical stimulation device (Quark, Brazil).
Receives: Device: TIBIAL TRANSCUTANEOUS ELECTROSTIMULATION; Behavioral: behavioral therapy protocol
GS (Sham-sham group): Behavioral therapySham comparatorGS (Sham-sham group): submitted to a behavioral therapy protocol, which involves bladder training, pelvic floor muscle training and modification of liquid intake. The orientation will be based on the initial evaluation of the patient, in which the responsible researcher will give verbal orientations and deliver booklets on the pathology, behavioral therapy and sleep hygiene. Twelve sessions will be held, twice a week, on non-consecutive days. The electrodes of the DUALPEX 961 equipment will be positioned one immediately posterior to the lateral malleolus of the ankle and the other approximately 30 cm above it, where there is no stimulus for the tibial nerve.
Receives: Behavioral: behavioral therapy protocol

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Nocturia

    People with an overactive bladder can experience nocturia, which means they need to get up frequently at night to go to the bathroom. Nocturia will be evaluated through the voiding diary that the volunteers will be instructed to complete. The more times the volunteer gets up at night to urinate, the more severe the condition.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

Secondary outcomes (12)
  1. sleep quality

    Assessed by the Pittsburgh Sleep Quality Index (PSQI), with the global score ranging from 0 to 21. The higher, the worse the sleep quality.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  2. physical activity level

    lifestyle based on the daily number of steps

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  3. sedentary behavior

    lifestyle based on the daily number of steps

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  4. anxiety level

    A mental health disorder characterized by feelings of worry, anxiety, or fear that are strong enough to interfere with daily activities. Screening for study anxiety will be performed using the the Hospital Anxiety and Depression Scale (HADS). The scale is validated for Portuguese and was developed to identify possible cases of anxiety and depression through a structured and easy-to-apply questionnaire.The HADS consists of two subscales of 14 varied questions: 7 questions that measure anxiety (HADS-A) and 7 that measure depression (HADS-D). Each question has four possible answers and a score from 0 to 3 is given. The total score is then calculated and can range between 0 and 21 points on each subscale, with a higher score indicating more severe symptoms. The cut-off score for "possible cases" of anxiety and depression is 8 points or higher, which is the cut-off identified to provide the optimal balance between specificity and sensitivity.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  5. Sleep parameters - Total time of sleep

    Total time the individual spent sleeping during the night

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  6. Excessive daytime sleepiness

    discrete quantitative variable, assessed using the Epworth sleepiness scale 1 ( ) yes, 2 ( ) no. It is a self-administered questionnaire and refers to the possibility of napping in eight everyday situations.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  7. Severity of urinary incontinence

    To identify how much the urinary incontinence impacts one's life.The severity of UI will be assessed using the Incontinence Severity Index (ISI), translated and validated into Portuguese by Pereira et al, in 2011 (Appendix 1)(126). This instrument consists of two questions regarding the frequency (1-4 points) and amount (1-3 points) of urinary loss. To obtain the final score, the scores for frequency of urinary leakage and the amount of urinary leakage are multiplied.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  8. Life's quality

    The SF-36 Medical Outcomes Study 36 - Item Short - Form Health Survey (SF36) is a generic instrument for assessing quality of life that is easy to administer and understand. It consists of a multidimensional questionnaire, consisting of 36 items, encompassed in 8 scales or domains. It has a final score from 0 to 100 (obtained by calculating the Raw Scale), where 0 corresponds to the worst general health status and 100 corresponds to the best health status.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  9. Sleep parameters - sleep efficiency

    Sleep efficiency is the relationship between the time the patient spent in bed and the actual sleep time.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  10. Sleep parameters - Total time in bed

    Total time in bed, whether sleeping or not.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  11. Sleep parameters - Nightly awakenings

    Number of times the individual wakes up during the night

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

  12. Sleep parameters - Time awake after falling asleep

    Time awake after sleep started, total time of nocturnal awakenings.

    Measured: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted21 Oct 2022
  2. Study start23 Jan 2023
  3. Primary completion30 Oct 2023
  4. Study completion30 Dec 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
103 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05590481
Sponsor's protocol ID
TIBIALTENS
Acronym
TibialTNS
Status last verified
Sep 2024
First submitted
29 Aug 2022
Last updated
19 Sep 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No

Questions about this trial

What is this clinical trial studying?

A study testing TIBIAL TRANSCUTANEOUS ELECTROSTIMULATION and behavioral therapy protocol in people with Urinary Incontinence, Urge, run by Instituto Materno Infantil Prof. Fernando Figueira at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 19 Sep 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Nocturia (time frame: Baseline/ change after the 6th week of treatment /change 30 days after the 6th week of treatment(follow up).). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 19 Sep 2024.

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