Bladder control problems after stroke are common (up to 79% of strokes each year), and have a huge impact on the stroke survivor and their long-term recovery. Problems controlling the bladder are linked to depression and isolation from social activity, with standard treatment programmes aimed at containment of symptoms only.
The current study investigates safe, mild, electrical stimulation of the leg, to relieve bladder symptoms caused by stroke. Such treatment has already been shown to reduce urinary incontinence (bladder control weakness) in elderly people in care homes.
Here’s how it works:
Nerves that control the bladder are connected to the ‘posterior tibial nerve’, which is located on the back of the lower leg. By stimulating this nerve through the skin, nerves that control the bladder are stimulated as well. This is known as transcutaneous posterior tibial nerve stimulation (TPTNS).
TPTNS is delivered by a TENS (transcutaneous electrical nerve stimulation) device through two sticky pads stuck on the skin, and may feel like a mild tingling sensation when used. TENS devices are widely available and affordable.
Eighty stroke survivors with bladder control problems will take part in the study. Half will receive TPTNS and half will receive a ‘dummy’ stimulation which won’t affect the posterior tibial nerve, but will feel the same. This home treatment will consist of 30 minutes of stimulation, twice a week for 6 weeks. All participants will be re-assessed at 6, 12 and 26 weeks after treatment has finished.
If the study is successful, it will lead to a full-scale, definitive multi-centre trial.