Effect of Transcutaneous Electrical Stimulation on Constipation

Summary

Cerebral palsy (CP) is a group of non-progressive neurological disorders that affect body movement, muscle coordination, and posture .It is caused by damage in developing brain, usually before or during birth, but can also occur during early childhood. They may include muscle stiffness or floppiness, abnormal reflexes, impaired coordination, difficulty with fine motor skills, speech and swallowing difficulties, involuntary movements, problems with balance and posture, and intellectual or developmental disabilities. Constipation is a common gastrointestinal issue in children with cerebral palsy (CP) due to reduced muscle tone, impaired coordination, limited mobility, and side effects of certain drugs like antispasmodics or anti-epileptics. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive therapy. Usually, TENS is commonly used as pain management modality, its role in treating constipation in children with cerebral palsy is still being explored. Research on the use of TENS for constipation in children with cerebral palsy is limited, and most studies have focused on constipation in adults or individuals without CP. However, some studies have investigated the effects of TENS on gastrointestinal function in children with CP, including constipation.

This study was Randomized Controlled Trial with random sampling technique. Study was conducted in DHQ Hospital, Hafizabad from July 2023 to December 2023 on 34 children with cerebral palsy with constipation having age from 1 to 6 years according to inclusion and exclusion criteria. After recruitment, it was divided into two Groups. Baseline treatment was provided to control group while TENS will be used in other experimental group. TENS was applied on abdominal area for 20 minutes along with baseline treatment. Record pre and post session history of patient defecation frequency per week, abdominal pain or discomfort, and type of stool via using Rome-IV criteria, Bristol Stool Scale, Constipation Assessment scale and Gross Motor Function Classification System before and after treatment. Data Analyses was based on statistical parameters and comparison performed before and after application of treatment.

Conditions

• Cerebral Palsy
• Constipation

Interventions

DEVICE

Transcutaneous Electrical Nerve Stimulation(TENS)

Defecation frequency per week, abdominal pain or discomfort, type of stool, severity of the constipation, frequency and consistency of stool, were measured before the commencement of treatment by using Romes-IV criteria, Visual Analogue Scale (VAS),Bristol Stool Scale (BSS),Gross Motor Functional Classification System (GMFCS) and Constipation Assessment Scale(CAS).After taking the measurements apply TENS on abdomen i.e. on the lower gastrointestinal tract, placed two skin electrodes of TENS on the abdomen lateral to the umbilicus and other two electrodes on back side at T9-L2 level for a month (20 minutes per session and 3 times a week) along with baseline treatment in which general movements were performed. After the completion of treatment same tools were used to re-assess the defecation frequency per week, abdominal pain or discomfort, type of stool, and severity of the constipation, frequency and consistency of stool for the measurement of final reading(Pre and post-treatment).

OTHER

Baseline Treatment

In control group, after the recruitment of participants according to the inclusion criteria. The baseline measurement were recorded by using Romes-IV criteria, Visual Analogue Scale (VAS), Bristol Stool Scale (BSS),Gross Motor Functional Classification System (GMFCS) and Constipation Assessment Scale(CAS). The baseline treatment is given in which general movements were performed i.e. Double knee-to-chest movement, sitting, standing, rolling as well as stretching of calf, hamstrings, adductors of both sides. Again assess the patient severity of constipation, frequency and consistency of stool, abdominal pain and functional status after the end of last session of the treatment(Pre and Post-treatment method).

Sponsors & Collaborators

• Riphah International University

  lead OTHER

Principal Investigators

• Ushna Yalnaz, MS* · Riphah International University

Study Design

Allocation

RANDOMIZED

Purpose

OTHER

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

1 Year

Max Age

6 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2023-12-01

Primary Completion

2024-02-05

Completion

2024-02-05

Countries

• Pakistan

Study Locations