Neuromodulación periférica en el síndrome de vejiga hiperactiva en mujeres: una revisión sistemática / Peripheral neuromodulation in women with overactive bladder syndrome: a systematic review

Introducción: El síndrome de vejiga hiperactiva (VH) es una disfunción urológica caracterizada por urgencia miccional, aumento de la frecuencia de las micciones, nicturia y puede llevar asociado incontinencia urinaria de urgencia. Dentro de las técnicas de tratamiento, la neuromodulación periférica del nervio tibial posterior (NMTP) está reconocida internacionalmente como una de las vías de abordaje, aunque no se ha probado un protocolo óptimo. El objetivo de esta revisión es conocer la evidencia disponible sobre cuál es el protocolo de la técnica de NMTP más empleado en la obtención de buenos resultados en el tratamiento de VH en mujeres.Adquisición de la evidenciaSe llevó a cabo una revisión sistemática de la literatura científica en las bases de datos Pubmed, Embase, WOS y Scopus. Se obtuvieron 222 resultados, con 58 duplicados, de los cuales 8 estudios cumplieron los criterios de inclusión establecidos, todos ellos ensayos clínicos aleatorizados.Síntesis de la evidenciaLa técnica de NMTP más utilizada en los trabajos incluidos que muestran estos resultados beneficiosos en mujeres con VH es la percutánea con una aguja colocada 5-6cm en posición proximal al maléolo tibial, por detrás del borde de la tibia y con los parámetros de 200μs de duración de impulso, 20Hz de frecuencia, 30 minutos de tiempo por sesión y con una frecuencia que podría ser de una sesión por semana durante 12 semanas.ConclusiónLa NMTP puede tener efectos beneficiosos y seguros a corto plazo en la VH en mujeres. A pesar de mostrar mejorías estadísticamente significativas en los síntomas clínicos, son necesarias más investigaciones para poder obtener evidencias científicas claras sobre el tipo de protocolo óptimo para el tratamiento de la VH en mujeres. (AU)

Introduction: Overactive bladder syndrome (OBS) is a urological disorder characterized by urinary urgency, increased frequency, nocturia, and may be associated with urge urinary incontinence. Posterior tibial nerve peripheral neuromodulation (PTNS) is globally recognized within the treatment options available, although an optimal protocol has not been tested. The objective of this review is to collect the evidence available on the most widely used protocol of the PTNS technique in obtaining good results in the treatment for women with OBS.Evidence acquisitionA systematic review of the scientific literature was carried out in PubMed, Embase, WoS and Scopus databases. A total of 222 results were obtained, with 58 duplicates, of which 8 studies met the established inclusion criteria, all of them randomized clinical trials.Evidence synthesisThe included works show that the most widely used PTNS technique with beneficial results in women with OBS is the percutaneous route with a needle placed 5-6cm proximal to the tibial malleolus, posterior to the edge of the tibia, with the following parameters: 1 weekly session of 30minutes duration for 12 weeks, the use of pulse widths of 200μs with frequency of 20Hz.ConclusionPTNS may have beneficial and safe short-term effects in women with OBS. Despite showing statistically significant improvements in clinical symptoms, further research is needed to obtain clear scientific evidence on the optimal protocol for treating women with OBS. (AU)

Peripheral neuromodulation in women with overactive bladder syndrome: a systematic review. / Neuromodulación periférica en el síndrome de vejiga hiperactiva en mujeres: una revisión sistemática.

INTRODUCTION: Overactive bladder syndrome (OBS) is a urological disorder characterized by urinary urgency, increased frequency, nocturia, and may be associated with urge urinary incontinence. Posterior tibial nerve peripheral neuromodulation (PTNS) is globally recognized within the treatment options available, although an optimal protocol has not been tested. The objective of this review is to collect the evidence available on the most widely used protocol of the PTNS technique in obtaining good results in the treatment for women with OBS. EVIDENCE ACQUISITION: A systematic review of the scientific literature was carried out in PubMed, Embase, WoS and Scopus databases. A total of 222 results were obtained, with 58 duplicates, of which 8 studies met the established inclusion criteria, all of them randomized clinical trials. EVIDENCE SYNTHESIS: The included works show that the most widely used PTNS technique with beneficial results in women with OBS is the percutaneous route with a needle placed 5-6cm proximal to the tibial malleolus, posterior to the edge of the tibia, with the following parameters: 1 weekly session of 30minutes duration for 12 weeks, the use of pulse widths of 200µs with frequency of 20Hz. CONCLUSION: PTNS may have beneficial and safe short-term effects in women with OBS. Despite showing statistically significant improvements in clinical symptoms, further research is needed to obtain clear scientific evidence on the optimal protocol for treating women with OBS.

Spanish adaptation and validation of the Mobile Application Rating Scale questionnaire.

INTRODUCTION AND AIM: In recent years, numerous health-related apps have appeared on the market, and assessing their quality has become crucial. A very popular tool worldwide, created especially for this purpose, is the Mobile Application Rating Scale (MARS). However, there are no similar tools in Spanish. Therefore, the aim of this paper is to adapt MARS to the Spanish language and validate the resultant version. METHOD: The design consists of three processes: cross-cultural adaptation, translation, and metric evaluation. 46 mobile applications, 23 of which were for Apple telephones and 23 of which were for telephones running Android, were included in the study. The main objective of these applications was to promote physical activity. The internal factor structure and reliability of MARS were examined. RESULTS: No major differences were observed in the two Spanish translations, which were carried out independently. The blind back-translation, reviewed by the original author of MARS, suggested minor edits. Discrimination indices (item-scale correlation) obtained appropriate results for both raters. The reliability of the scores was found to be appropriate both in terms of internal consistency (α > 0.77), temporal stability (r > 0.72), and inter-rater reliability (IC > 0.76). The correlations between the subscales have shown high values with range between 0.47 and 0.83. CONCLUSION: The Spanish version of MARS was shown to have appropriate metric properties to assess the quality of health apps.

Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain.

This study investigated effectiveness of manual therapy (MT) with transcutaneous electrical nerve stimulation (TENS) to reduce pain intensity in patients with mechanical neck disorder (MND). A randomized multi-centered controlled clinical trial was performed in 12 Primary Care Physiotherapy Units in Madrid Region. Ninety patients were included with diagnoses of subacute or chronic MND without neurological damage, 47 patients received MT and 43 TENS. The primary outcome was pain intensity measured in millimeters using the Visual Analogue Scale (VAS). Also disability, quality of life, adverse effects and sociodemographic and prognosis variables were measured. Three evaluations were performed (before, when the procedure finished and six months after). Seventy-one patients (79%) completed the follow-up measurement at six months. In more than half of the treated patients the procedure had a clinically relevant "short term" result after having ended the intervention, when either MT or TENS was used. The success rate decreased to one-third of the patients 6 months after the intervention. No differences can be found in the reduction of pain, in the decrease of disability nor in the quality of life between both therapies. Both analyzed physiotherapy techniques produce a short-term pain reduction that is clinically relevant.