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Optimizing Percutaneous Tibial Nerve Stimulation Intensity for Overactive Bladder Using a Motion Capture System
Linquan Jin1, Dongsheng Shang1, Han Deng2
1Department of Rehabilitation, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China; Department of Urology, Rehabilitation School of Capital Medical University, China Rehabilitation Research Center, Beijing, China.
Motion capture (MoCap) technology identified a lower, safer stimulation intensity for percutaneous tibial nerve stimulation (PTNS) that effectively treats overactive bladder (OAB). This optimized intensity reduces discomfort and enhances therapy personalization for OAB patients.
Area of Science:
- Biomedical Engineering
- Neuroscience
- Urology
Background:
- Overactive bladder (OAB) presents a significant global health challenge.
- Current percutaneous tibial nerve stimulation (PTNS) protocols involve maximal-tolerance intensity, leading to patient discomfort and side effects.
- Optimizing PTNS intensity is crucial for improving treatment safety and patient compliance.
Purpose of the Study:
- To optimize percutaneous tibial nerve stimulation (PTNS) intensity for overactive bladder (OAB) treatment.
- To evaluate the efficacy of a motion capture (MoCap) system in determining a personalized and safer stimulation threshold.
- To compare the therapeutic outcomes of MoCap-determined intensity with the standard maximal-tolerance intensity.
Main Methods:
- A motion capture (MoCap) system, utilizing an inertial measurement unit (IMU), was employed to establish a novel stimulation threshold (t).
- Conventional threshold intensity (T) was determined by visual observation of toe flexion.
- The effects of PTNS at 2T and 2t on the micturition reflex were assessed using cystometrograms (CMGs) in a feline model during normal saline (NS) and acetic acid (AA) infusion.
Main Results:
- Both 2T and 2t PTNS significantly increased bladder capacity during NS infusion (p < 0.01).
- During AA-induced bladder irritation, both 2T and 2t PTNS restored bladder capacity (p < 0.01), with MoCap-derived threshold (t) being significantly lower than conventional threshold (T) (p < 0.05).
- Angular velocity and linear acceleration measured by IMU correlated positively with stimulation intensity, validating MoCap's utility.
Conclusions:
- The IMU-based MoCap system successfully identified a lower stimulation threshold that yields therapeutic effects comparable to conventional PTNS protocols.
- This approach has the potential to reduce stimulation intensity, thereby enhancing the safety and personalization of PTNS for OAB management.
- Further research is warranted to validate these findings in clinical settings for long-term OAB treatment.