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This research found a limitation in the loss of
patient sensibility caused by MS.
According to Tilbery (2006), it is common for
patients with MS to present paraparesis of varying
intensity, especially in the lower limbs. Therefore,
the difficulty of using electrotherapy with these
patients consists in adjusting the intensities of the
current. We propose to perform the sensitivity test
before applying the therapeutic current. During
electrical stimulation it is important to carefully
observe the threshold of individuals with
hypersensibility. For that reason, the current
intensity should be slowly graded until reaching an
individualized parameter below the stimulation
threshold of motor innervation (Kabay et al, 2009;
Amarenco, 2003; Fischer-Sgrott et al, 2009; Maciel
and Souto, 2009).
5 CONCLUSIONS
The transcutaneous electrical stimulation in the
posterior tibial nerve can be considered as an
alternative in the treatment of urinary incontinence
in detrusor hyperactivity. Our results suggest that the
technique may be effective in reducing the
uninhibited detrusor contractions after 10 sessions of
electrostimulation.
This technique is also relatively inexpensive,
non-invasive, non-embarrassing, comfortable,
painless, effective, with targeted action on the
detrusor muscle, easy to apply and free of side
effects of medications. Also, we believe that it can
have high acceptance and adherence by the patients,
since it does not result in great discomfort and each
session takes 20 minutes.
We emphasize that, in this study, the technique
resulted in a reduction in daytime and nighttime
urinary frequency and in the number of episodes of
urge incontinence. It can then have an impact in
reducing stress and embarrassment and the number
of urinary tract infections, as well as improving
sleep quality and mood and thus providing a better
quality of life for individuals with MS. It is then a
good alternative in the treatment of lower urinary
tract dysfunction, as suggested by the patient in this
study.
ACKNOWLEDGEMENTS
We leave to express our sincere thanks to Doctor
Denise Sistorelli Diniz, a neurologist at the Hospital
das Clínicas, Federal University of Goiás, for
supporting our research. The authors thank the
Alfredo Nasser Scholl (Unifan).
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