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Chronic Spinal Cord InjuryHomeTTNSNCT03458871

Home Neuromodulation of the Neurogenic Bladder in Chronic Spinal Cord Injury With Transcutaneous Tibial Nerve Stimulation

A study testing 4-week TTNS home-based protocol in people with Chronic Spinal Cord Injury and Neurogenic Bowel, run by The University of Texas Health Science Center, Houston at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Determine the safety, feasibility, compliance, and efficacy of a daily home TTNS protocol in chronic SCI provided by self or caregiver for 4 weeks. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
Chronic Spinal Cord Injury, Neurogenic Bowel
What is being tested?
4-week TTNS home-based protocol
Type of treatment
Medical device
Could I receive a placebo?
No, everyone receives an active treatment
How many people
16 participants
Where
1 siteUnited States
Study dates
13 Mar 2018to 6 Feb 2019
Phase
Interventional
Are there results?
Yes, posted in the registrySummary in the doctors' view

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18-65 years old
  • Neurologically stable SCI for ≥ 6 months
  • Intermittent catheterization to empty bladder
  • Stable bladder medications for ≥ 3 months

Who cannot join

  • Multiple medications for the bladder
  • Other diagnoses to explain incontinence (ex: UTI, bladder stones, multiple sclerosis, etc.)
  • 2+ pitting edema that does not resolve
  • Known peripheral neuropathy or injury to the path of the tibial nerve
  • Demand-type cardiac pacemaker or implanted defibrillator
  • Cancer in the tibial nerve path and/or bladder
Show all 9Show fewer
  • Inability to elicit toe/plantar flexion with electric stimulation during the clinic visit.
  • Inability to understand directions
  • Non-English speaking

Trial locations and contacts

1 site in 1 country.

United States1 site
  • The University of Texas Health Science Center at Houston

    Houston, Texas, 77030

Other trials in United States

About this study

Determine the safety, feasibility, compliance, and efficacy of a daily home TTNS protocol in chronic SCI provided by self or caregiver for 4 weeks.

Read the detailed description

In Specific Aim 1, we will monitor for safety, feasibility, and compliance of a home TTNS program for bladder management. In Specific Aim 2, the efficacy of home TTNS will be compared to baseline Incontinence- Quality of Life questionnaire. A bladder diary will also capture important information such as frequency and volume of catheterization, incontinence episodes, and other related observations.

Being tested
4-week TTNS home-based protocol
Keywords
electric stimulation
Medical subject headings
Neurogenic Bowel

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • 4-week TTNS home-based protocolDevice

    4-week TTNS home-based protocol. Electrodes 2 inch by 2 inch will be placed according to anatomic landmarks, with the negative electrode behind the internal malleolus and the positive electrode 10cm superior to the negative electrode, verified with rhythmic flexion of the toes secondary to stimulation of the flexor digitorum and hallicus brevis. The intensity level will be set to the amperage immediately under the threshold for motor contraction. If there is not contraction seen, maximal tolerable intensity will be used.

    In addition, if the patient perceives pain, the intensity will be lowered until comfortable.

    Stimulation frequency of 10 Hz and pulse width of 200ms in continuous mode will be used.

Study groups in NCT03458871
Study groupRoleWhat they receive
4-week TTNS home based protocolExperimentalTranscutaneous Tibial Nerve Stimulation (TTNS) applied to subjects for 4-week protocol.
Receives: Device: 4-week TTNS home-based protocol

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Safety of Using TTNS at Home Daily as Indicated by Number of Adverse Events Recorded in Bladder Diary

    Noted on bladder diary will be description of observed changes including but not limited to pain, fatigue, vision changes, mental status, bowel program changes, and sexual function changes. The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 1

  2. Safety of Using TTNS at Home Daily as Indicated by Number of Adverse Events Recorded in Bladder Diary

    Noted on bladder diary will be description of observed changes, including but not limited to pain, fatigue, vision changes, mental status, bowel program changes, and sexual function changes. The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 2

  3. Safety of Using TTNS at Home Daily as Indicated by Number of Adverse Events Recorded in Bladder Diary

    Noted on bladder diary will be description of observed changes, including but not limited to pain, fatigue, vision changes, mental status, bowel program changes, and sexual function changes. The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 3

  4. Safety of Using TTNS at Home Daily as Indicated by Number of Adverse Events Recorded in Bladder Diary

    Noted on bladder diary will be description of observed changes, including but not limited to pain, fatigue, vision changes, mental status, bowel program changes, and sexual function changes. The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 4

  5. Compliance as Assessed by Number of Days Per Week TTNS Was Used, as Recorded at Home Daily in Bladder Diary

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 1

  6. Compliance as Assessed by Number of Days Per Week TTNS Was Used, as Recorded at Home Daily in Bladder Diary

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 2

  7. Compliance as Assessed by Number of Days Per Week TTNS Was Used, as Recorded at Home Daily in Bladder Diary

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 3

  8. Compliance as Assessed by Number of Days Per Week TTNS Was Used, as Recorded at Home Daily in Bladder Diary

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 4

  9. Overall Satisfaction of Daily Use of TTNS at Home

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 1

  10. Overall Satisfaction of Daily Use of TTNS at Home

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 2

  11. Overall Satisfaction of Daily Use of TTNS at Home

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 3

  12. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "TTNS Was Easy to Use"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  13. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "It Was Not Embarrassing to Use TTNS"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  14. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "It Was Easy to Remember to Use TTNS"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  15. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "TTNS Did Not Irritate my Skin"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  16. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "TTNS Was Not Painful"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  17. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "TTNS Improved my Quality of Life"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  18. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "I Enjoyed Using TTNS"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  19. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "If TTNS Works as Well as Medications, I Would Switch to TTNS"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

  20. Overall Satisfaction of Daily Use of TTNS at Home as Assessed by a TTNS Satisfaction Survey - Item "Overall, I Would Recommend TTNS for Those With Neurogenic Bladder"

    The TTNS satisfaction survey ranges from 0 (strongly disagree) to 10 (strongly agree), with higher scores indicating greater satisfaction.

    Measured: week 4

Secondary outcomes (7)
  1. Quality of Life as Assessed by Score on Incontinence of Quality of Life (I-QOL) Survey

    Total score on the I-QOL survey is reported. The total score ranges from 0 (poor quality of life) to 100 (maximum quality of life), with a higher score indicating a better quality of life.

    Measured: week 0

  2. Quality of Life as Assessed by Score on Incontinence of Quality of Life (I-QOL) Survey

    Total score on the I-QOL survey is reported. The total score ranges from 0 (poor quality of life) to 100 (maximum quality of life), with a higher score indicating a better quality of life.

    Measured: Week 2

  3. Quality of Life as Assessed by Score on Incontinence of Quality of Life (I-QOL) Survey

    Total score on the I-QOL survey is reported. The total score ranges from 0 (poor quality of life) to 100 (maximum quality of life), with a higher score indicating a better quality of life.

    Measured: week 4

  4. Number of Catheterizations Per Day

    Frequency of catheterization after TTNS. The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 1, week 2, week 3, week 4

  5. Volume of Catheterization

    The research assistant will call weekly to capture the written data and monitor progress with the protocol.

    Measured: week 1, week 2, week 3, week 4

  6. Anticholinergic Side Effect Severity as Assessed by an Anticholinergic Side Effect Severity of Symptom Questionnaire

    Items on the anticholinergic side effect severity of symptom questionnaire is scored as 0 (None), 1 (Mild), 2 (Moderate), or 3 (Severe), with a higher score indicating a worse outcome.

    Measured: week 0

  7. Anticholinergic Side Effect Severity as Assessed by an Anticholinergic Side Effect Severity of Symptom Questionnaire

    Items on the anticholinergic side effect severity of symptom questionnaire is scored as 0 (None), 1 (Mild), 2 (Moderate), or 3 (Severe), with a higher score indicating a worse outcome.

    Measured: week 4

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted8 Mar 2018
  2. Study start13 Mar 2018
  3. Primary completion6 Feb 2019
  4. Study completion6 Feb 2019

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
16 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03458871
Sponsor's protocol ID
HSC-MS-17-0423
Acronym
HomeTTNS
Status last verified
Oct 2021
First submitted
26 Feb 2018
Last updated
29 Oct 2021
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes

Publications

  • Stampas A, Korupolu R, Lee KH, Salazar B, Khavari R. Reduction of Overactive Bladder Medications in Spinal Cord Injury With Self-Administered Neuromodulation: A Randomized Trial. J Urol. 2024 Dec;212(6):800-810. doi: 10.1097/JU.0000000000004189. Epub 2024 Aug 2.

    PubMed 39093916

Questions about this trial

What is this clinical trial studying?

A study testing 4-week TTNS home-based protocol in people with Chronic Spinal Cord Injury and Neurogenic Bowel, run by The University of Texas Health Science Center, Houston at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 9 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 29 Oct 2021. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

Yes. Results are posted in the registry (first posted 4 Mar 2020). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Safety of Using TTNS at Home Daily as Indicated by Number of Adverse Events Recorded in Bladder Diary (time frame: week 1). The study lists 20 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT03458871, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Oct 2021.

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