Efeito da eletroestimulação trancutânea do nervo tibial sobre os sintomas urinários neurogênicos e qualidade de vida em mulheres com esclerose múltipla

Abstract

Multiple Sclerosis (MS) is a chronic, autoimmune, inflammatory and demyelinating disease that causes motor changes and dysfunction in the Lower Urinary Tract (LUT). Objective: To verify the effectiveness of Transcutaneous Electrostimulation of the Tibial Nerve (TRTN) associated with Pelvic Floor Muscle Training (PFMT) on Lower Urinary Tract Symptoms (LUTS) in women with MS. Method: Controlled Clinical Trial Study was developed with 29 women aged between 18 and 59 years, with a clinical diagnosis of MS at the Urology Outpatient Clinic of HUMAP/UFMS, who were distributed into two groups: Experimental Group (G1) and Control Group (G2). G1 (n=13) underwent two weekly sessions of EETT associated with PFMT for twelve weeks. G2 (n=16) performed PFMT at home twice a week for twelve weeks. Assessments took place at the beginning and end of the interventions (12 weeks) using the respective instruments: OAB-V8 which assesses the level of impairment of LUTS and Q-FS which assesses Quality of Life (QoL). Statistical analysis was carried out using the mean and standard deviation to characterize the data and the comparison of sample size was carried out using the chi-square test. Age and Expanded Illness Scale (EDSS) were assessed using the independent Student t test. The effects of therapies on OAB-V8 were performed using the Analysis of Variance for Repeated Measures test. Significance was admitted at 5% and effect size (ƞ2p) were reported when there was a significant difference between groups. Results: G1 had a mean age of 33.4 years and G2 was 36.9 years. The groups were homogeneous at the beginning of the study. Regarding urinary symptoms (OABV-8), the groups showed differences (P = 0.009; ƞ2p = 0.228). There was an oscillation with improvement in both groups (P = 0.001; ƞ2p = 0.606), but the improvement was greater in G1 who underwent EETT associated with PFMT (P = 0.001; ƞ2p = 0.353). Regarding QoL in general, the groups showed similar patterns (P = 0.115). There was a fluctuation in values in both groups (P = 0.001; ƞ2p = 0.456), but the improvement was greater in group G1 (P = 0.001; ƞ2p = 0.353). Conclusion: The results reinforce the benefits of EETT associated to PFMT in reducing LUTS and improving QoL in terms of concerns about limitations and associated negative feelings in women with MS.