Comparison of the efficiency of transcutaneous electrical nerve stimulation and manual therapy in children with cerebral palsy with lower urinary system dysfunction- a randomized prospective trial.

Many children with cerebral palsy experience bladder problems such as urgency, frequent urination, and incontinence, alongside the more widely recognised motor difficulties. This trial compared two non-drug physiotherapy approaches, a sacral electrical stimulation technique called TENS and manual abdominal massage, given twice weekly for 12 weeks to 54 children with cerebral palsy and significant urinary symptoms. Both approaches were associated with improvements in urinary symptoms, bladder capacity, and quality of life over the study period. Incontinence episodes decreased more in the TENS group than the massage group, a difference reported as statistically significant, and the same pattern held for symptom scores and quality of life.

Massage appeared more effective for constipation symptoms specifically. The study was relatively small and did not include a no-treatment or placebo comparison group, so it cannot say how much of either group's improvement reflects the specific treatment versus other factors like attention from therapists or natural change over time.

If your child has cerebral palsy, you may already know that bladder issues like frequent urination, urgency, or accidents are common alongside movement difficulties. This study looked at two physiotherapy-based treatments for these bladder problems: a gentle electrical stimulation applied to the lower back area (called TENS) and abdominal massage, each given twice a week for 12 weeks to a group of 54 children. Both treatments were followed by improvements in bladder symptoms, how much urine the bladder could hold, and quality of life.

The TENS treatment showed a statistically greater improvement in accidents and overall symptom scores compared to massage, while massage seemed to help more with constipation. It is worth knowing this was a fairly small study without a comparison group that received no treatment, so we can't be fully certain how much of the improvement came specifically from either therapy rather than other factors, such as extra attention from the therapist or time passing.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This trial addresses a practical question in paediatric neurological rehabilitation: whether a non-pharmacological physiotherapy intervention can meaningfully affect lower urinary tract dysfunction in children with cerebral palsy, a problem affecting more than half of this population but often undertreated. Fifty-four children with a Dysfunctional Voiding Scoring System score of 8.5 or higher were randomised to 12 weeks of parasacral TENS or manual abdominal and colon massage, twice weekly. Both groups showed improvement in symptom scores, functional bladder capacity, and quality of life, but the between-group comparison favoured TENS for reduction in incontinence episodes, symptom score, and quality of life, while massage showed a between-group advantage for constipation outcomes.

Functional bladder capacity improved in both groups without a statistically significant between-group difference. These findings suggest TENS may offer additional benefit over massage for certain urinary outcomes specifically, though the trial had no untreated or sham comparator, so attention and natural symptom fluctuation cannot be excluded as contributors, particularly for self-reported measures like quality of life.

The sample size is modest and the abstract does not report longer-term follow-up, adverse events, or blinding procedures, so durability and safety remain unestablished from this report alone.