Patterned Electrical Neuromuscular Stimulation Decreases the Incidence of Incontinence in Elderly Patients

抄録

The purpose of this study was to determine if Patterned Electrical Neuromuscular Stimulation (PENS) and Medium Frequency Alternating Current (MFAC) would decrease the incidence of urinary incontinence (UI) in institutionalized elderly patients. The study subjects comprised 55 women (mean age of 85.14 years) who were residents of skilled nursing facilities. All patients received three, 20-minute PENS treatments per week for 6 weeks, applied to the T10-L2 paraspinal and suprapubic abdominal muscles as well as to the L1-2 and Sacral S2-S4 proximal medial thigh dermatomes and muscles. Additionally, 16 of the patients also received MFAC to the pelvic floor for 10 minutes immediately after the PENS treatment. We compared incidences of UI prior to and after the program in subjects who suffered from urge or mixed types of UI. On average, subjects in the PENS only group improved 73%, whereas subjects in the PENS and MFAC group improved 66%. Overall, 92% of the patients reported satisfaction with the incontinence program and would recommend this treatment to others who are incontinent. The follow-up progress notes of 18 patients were reviewed 4 weeks post discharge and only one patient did not maintain the improved status. Both PENS and MFAC are effective in treating patients with UI. PENS achieves the neuromuscular re-education of the pelvic muscle complex and modulates the urge sensation ; whereas MFAC is used to strengthen the pelvic floor and sphincter muscles.