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CompletedNCT02747849Updated Apr 21, 2023Results posted

Hand & Foot Nocturnal Enuresis TENS Study

An interventional study of TENS in Bedwetting, sponsored by Rajeev Chaudhry. Completed at 1 site in United States. Open to participants aged 5 Years to 18 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2023-04-21.

Sponsored by Rajeev Chaudhry · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
27
Allocation
Randomized
Ages
5 Years to 18 Years
Sex
All
01

Study summary

The investigators believe in order to strengthen the evidence in support of transcutaneous foot stimulation in this population the investigators need to move forward with a randomized comparison study using the TENS device on the hand and foot as a control.

Read the detailed description

Nocturnal enuresis is a common problem in children which can have a dramatic psychological and social impact on quality of life. Neuromodulation by transcutaneous foot stimulation of peripheral tibial nerve branches has been shown to produce a prolonged inhibition of micturition reflex contractions and significantly increase bladder capacity. The investigators primary goal was to evaluate the effect of foot stimulation on the frequency of nocturnal enuresis episodes in children.

02

Conditions studied

  • Bedwetting
03

Who can participate

Ages eligible
5 Years to 18 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Inclusion criteria

  1. Children ages 5 to 18 years old without any specific neurological disorder or urinary tract infection, clinically diagnosed as having nocturnal enuresis AT LEAST 4 episodes per month by history, nocturnal enuresis is a DSM V diagnosable medical condition
  2. Currently having no daytime overactive bladder symptoms, i.e. urinary frequency, urgency, or daytime incontinence
  3. Having been assessed for and treated if applicable for behavioral etiologies of nocturnal enuresis - consuming excess fluids or specific bladder irritants
  4. Having been assessed for and treated if applicable for constipation

Exclusion criteria

Exclusion Criteria:

  1. Children with known neurological disorders which may be contributing to nocturnal enuresis episodes
  2. Children found through history to have significant behavioral causes of nocturnal enuresis including consumption of excessive fluids or known bladder irritants
  3. Children with chronic constipation who are non-compliant with previous pharmacologic efforts to treat.
  4. Children who are not adequately potty trained
  5. Children with significant daytime symptoms of overactive bladder including frequency, urgency, and daytime incontinence
  6. Children who do not tolerate initial stimulation training session in the urology clinic upon enrollment
  7. Children with any implantable medical devices such as a pacemaker will be excluded from the study

Note: Any patient currently taking medication such as an anti-muscarinic or a tricyclic antidepressant for overactive bladder at time of enrollment will be eligible to participate and will be continued on their usual medication and dosage throughout the study.

04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
27 participants (actual)

Study arms

  • Placebo comparator
    Hand neuromodulation

    The stimulation characteristics for this arm include a continuous frequency of 5 Hz, pulsewidth 0.2 ms, and intensity 2-4 times the threshold voltage required for finger twitching - or the intensity that the subject feels comfortable with. Subjects will be asked to use the stimulator for a minimum of 60 minutes prior to bedtime for two weeks, or longer if they can tolerate it, have the time, and accurately record the total duration. Stimulation will be performed during the first, second, and third weeks of the study.

    Device: TENS

  • Active comparator
    Foot Neuromodulation

    The stimulation characteristics include a continuous frequency of 5 Hz, pulsewidth 0.2 ms, and intensity 2-4 times the threshold voltage required for inducing toe twitching - or the intensity that the subject feels comfortable with. The subjects will be asked to wear socks on their foot to prevent the electrodes from detachment and to stop the stimulation during walking or in any non-resting situation. Subjects will be asked to use the stimulator for a minimum of 60 minutes prior to bedtime for two weeks, or longer if they can tolerate it, have the time, and accurately record the total duration. Stimulation will be performed during the first, second, and third weeks of the study.

    Device: TENS

Interventions

  • DeviceTENS

    Placebo had stimulator placed on hand. Active comparator had stimulator placed on foot. Amount of time, intensity, threshold voltage, pulsewidth and frequency remained the same for both arms.

05

What researchers measure

Primary outcomes

  1. Change in Number of Nights Wet Per 2 Weeks

    The subject/parents will be instructed to record a night-time voiding log specifying the change in number of nights wet per 2 weeks. This log is included in the IRB application. Subjects/parents will fill out the log for a two week period prior to foot stimulation to determine a baseline average of nocturnal enuresis episodes, during week 3 and 4 of the study the subjects will stimulate either their foot or hand to measure any acute effect on nocturnal enuresis episodes and finally during week 5 and 6 of the study, after stimulation subjects will keep a log to evaluate any post-stimulation residual benefit

    Time frame: 6 weeks

  2. Response to Treatment

    Total number of participants that responded to treatment after stimulation with Hand or Foor unit.

    Time frame: An average of 6 weeks

06

Results

Posted Apr 21, 2023

Participant flow

Participant flow — Overall Study
MilestoneHand NeuromodulationFoot Neuromodulation
Started1314
Completed1214
Not completed10

Outcome measures

PrimaryChange in Number of Nights Wet Per 2 Weeks

The subject/parents will be instructed to record a night-time voiding log specifying the change in number of nights wet per 2 weeks. This log is included in the IRB application. Subjects/parents will fill out the log for a two week period prior to foot stimulation to determine a baseline average of nocturnal enuresis episodes, during week 3 and 4 of the study the subjects will stimulate either their foot or hand to measure any acute effect on nocturnal enuresis episodes and finally during week 5 and 6 of the study, after stimulation subjects will keep a log to evaluate any post-stimulation residual benefit

Time frame:
6 weeks
Reported as:
Mean · # nights wet over 2 weeks
Change in Number of Nights Wet Per 2 Weeks
# nights wet over 2 weeksHand NeuromodulationFoot Neuromodulation
# nights wet before stimulation over 2 weeks11 ± 3.468.78 ± 4.12
# nights wet during stimulation over 2 weeks8.75 ± 3.996.22 ± 4.21
# nights wet after stimulation over 2 weeks9.5 ± 3.826.78 ± 5.19
PrimaryResponse to Treatment

Total number of participants that responded to treatment after stimulation with Hand or Foor unit.

Time frame:
An average of 6 weeks
Reported as:
Count of participants · Participants
Response to Treatment
ParticipantsHandFoot
Response to Treatment89

Adverse events

Collected over 6 weeks. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Hand Neuromodulation0/12 (0%)0/12 (0%)0/12 (0%)
Foot Neuromodulation0/14 (0%)0/14 (0%)0/14 (0%)

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Hand NeuromodulationFoot NeuromodulationTotal
<=18 years121426
Between 18 and 65 years000
>=65 years000
Age, Continuous
Age, Continuous(years)Hand NeuromodulationFoot NeuromodulationTotal
Mean12 (8 to 17)12.1 (8 to 17)12 (8 to 17)
Sex/Gender, Customized
Sex/Gender, Customized(Participants)Hand NeuromodulationFoot NeuromodulationTotal
Gender — Male9918
Gender — Female347
Gender — Did not identify011
Race and Ethnicity Not Collected
Race and Ethnicity Not Collected(Participants)Hand NeuromodulationFoot NeuromodulationTotal
Count of participants——0
Region of Enrollment
Region of Enrollment(participants)Hand NeuromodulationFoot NeuromodulationTotal
United States121426
07

Study locations

1 site
  • Children's Hospital of Pittsburgh og UPMC
    Pittsburgh, Pennsylvania 15224, United States
08

References and documents

Study documents

  • Protocol and statistical analysis plan · Jun 8, 2020

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No

09

Registry details

Key details

Study ID
NCT02747849
Lead sponsor
Rajeev Chaudhry
Collaborators
The Coulter Foundation
Responsible party
Rajeev Chaudhry (Assistant Professor, University of Pittsburgh) — Sponsor-investigator
First posted
Apr 22, 2016
Start date
Apr 2016
Primary completion
Dec 2021
Completion
Dec 2021
Results posted
Apr 21, 2023
Last update
Apr 21, 2023

Study contacts

Rajeev Chaudhry, MD
principal investigator · University of Pittsburgh
View the source record on ClinicalTrials.gov ↗

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This study is completed, as verified in Mar 2023. You cannot join it, but the record below documents what was studied.

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