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Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with
Abdol-Mohammad Kajbafzadeh1, Lida Sharifi-Rad, Farideh Nejat
1Pediatric Urology Research Center, Department of Pediatric Urology, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran. kajbafzd@sina.tums.ac.ir
Insights
Transcutaneous interferential (IF) electrical stimulation improved constipation and anorectal function in children with myelomeningocele (MMC). This safe, noninvasive therapy offers a promising solution for managing neurogenic bowel dysfunction in this population.
Area of Science:
- Pediatric Gastroenterology
- Neurorehabilitation
- Biomedical Engineering
Background:
- Children with myelomeningocele (MMC) often experience severe, intractable constipation due to neurogenic bowel dysfunction.
- Anorectal manometry is crucial for assessing rectal and anal function in these patients.
- Current management strategies for neurogenic bowel dysfunction in MMC can be invasive or have limited efficacy.
Purpose of the Study:
- To evaluate the efficacy of transcutaneous interferential (IF) electrical stimulation for improving constipation symptoms in children with myelomeningocele (MMC).
- To assess the impact of IF therapy on key anorectal manometry parameters, including sphincter pressure and the rectoanal inhibitory reflex.
Main Methods:
- A pilot study involving 30 children with moderate to severe intractable constipation due to MMC, aged 6.7 ± 2.9 years.
- Participants were randomized into two groups: treatment (IF stimulation, n=15) and control (sham stimulation, n=15).
- IF therapy involved 20-minute sessions, three times weekly for 6 months, with assessments including anorectal manometry, bowel habit diaries, and neurogenic bowel dysfunction scores.
Main Results:
- The treatment group showed significant improvements in sphincter pressure and rectoanal inhibitory reflex compared to the control and pre-treatment groups (P < .05).
- Constipation symptom improvement was observed in 73% of patients immediately after IF therapy, persisting in 53% at 6 months.
- The frequency of defecation significantly increased from 2.5 ± 1.1 per week to 4.7 ± 2.3 per week post-treatment (P < .001).
Conclusions:
- Transcutaneous interferential (IF) electrical stimulation is a safe and noninvasive therapeutic option for children with myelomeningocele (MMC).
- IF therapy effectively improves constipation symptoms and key anorectal manometry parameters in this pediatric population.
- This pilot study suggests IF stimulation is a viable modality for managing neurogenic bowel dysfunction in children with MMC.
Purpose:
We describe the efficacy of transcutaneous interferential (IF) electrical stimulation on constipation symptoms in children with myelomeningocele (MMC).
Methods:
MMC children (30, comprising of 17 girls and 13 boys), mean age 6.7 ± 2.9, with moderate to severe intractable constipation were enrolled in this study. They were divided into treatment (IF stimulation, 15 children) and control (sham stimulation, 15 children) groups. All children underwent anorectal manometry before and 6 months after IF therapy considering the rectoanal inhibitory reflex and sphincter pressure. Parents were instructed to complete a bowel habit diary by providing data on the number of defecations per week, form of stool and episodes of pain during defecation. According to parents' report a total neurogenic bowel dysfunction score questionnaire was filled before and 6 months after treatment. A 15-course abdominal area IF electrical stimulation was performed for 20 min and three times per week, with low-frequency current in a duration of 250 μs every 6 s. Children were followed up for a minimum period of 6 months.
Results:
In the treatment group, sphincter pressure and rectoanal inhibitory reflex significantly improved compared with sham stimulation and pretreatment measures (P < .05). In 73% of patients, the characteristics of constipation decreased immediately after IF therapy, while in 53% patients, they persisted for 6 months. Frequency of defecation increased statistically significant from 2.5 ± 1.1 per week before treatment to 4.7 ± 2.3 per week after treatment (P < .001).
Conclusions:
This pilot study showed that IF therapy is safe, noninvasive, and effective modality to improve constipation symptoms and anorectal manometry parameters in children with history of myelomeningocele.
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