Full metadata record
DC FieldValueLanguage
dc.contributorDepartment of Rehabilitation Sciencesen_US
dc.contributor.advisorKannan, Priya (RS)en_US
dc.contributor.advisorFong, Kenneth (RS)en_US
dc.contributor.advisorKranz, Georg (RS)en_US
dc.creatorAli, Mohammed Usman-
dc.identifier.urihttps://theses.lib.polyu.edu.hk/handle/200/13585-
dc.languageEnglishen_US
dc.publisherHong Kong Polytechnic Universityen_US
dc.rightsAll rights reserveden_US
dc.titleRepetitive transcranial magnetic stimulation for the treatment of neurogenic overactive bladder in stroke survivorsen_US
dcterms.abstractBackground: Neurogenic overactive bladder (OAB) causes significant distress to stroke survivors. Current treatments for neurogenic OAB are invasive, expensive, or lack standardized regimens. Therefore, evaluating the effectiveness of repetitive transcranial magnetic stimulation (rTMS) for managing neurogenic OAB among stroke survivors remains crucial.en_US
dcterms.abstractObjectives: To (1) determine the effects of nonsurgical, minimally or non-invasive therapies on urgency urinary incontinence (UUI) in neurogenic OAB, (2) identify psychometrically sound measures for assessing OAB symptoms, (3) identify psychometrically sound measures for evaluating quality of life in neurogenic OAB, (4) investigate the effectiveness of active rTMS compared to sham rTMS in alleviating neurogenic OAB symptoms among stroke survivors, (5) estimate the cost of active and sham rTMS in managing neurogenic OAB symptoms among stroke survivors, (6) explore the experiences of stroke survivors with neurogenic OAB symptoms after rTMS.en_US
dcterms.abstractMethods: A meta-analysis was conducted to determine the effects of non-invasive therapies on UUI symptoms in neurogenic OAB. Two systematic reviews were conducted to identify psychometrically sound measures for evaluating OAB symptoms and quality of life in neurological disorders. A total of 110 stroke survivors with neurogenic OAB symptoms were screened for eligibility; 60 participants were eligible and were randomly assigned to either the active (n = 30) or sham rTMS (n = 30) groups. The active rTMS group received low-frequency rTMS of 1200 pulses per session lasting 20 min thrice weekly. The sham rTMS group received low-frequency stimulation at a 20 % resting motor threshold. The primary (Overactive Bladder Symptom Score [OABSS]) and secondary (Incontinence Quality of Life [I-QOL] and Brief Resilience Scale [BRS]) outcome measures were assessed. The analysis of covariance (ANCOVA) analysis compared changes in the study groups. An estimate of the mean cost per patient was determined for study groups. Thematic analysis was utilised to explore the experiences of participants after active rTMS.en_US
dcterms.abstractResults: The meta-analysis revealed that electrical stimulations (intravaginal and neuromuscular stimulations) are efficacious in decreasing UUI symptoms due to multiple sclerosis and stroke. Among the identified clinical tools for neurogenic OAB symptoms and quality of life, OABSS and I-QOL, respectively, were the most psychometrically sound. The between-group mean difference (MD) of OABSS (effect size [ES]: 0.62) at the primary and secondary endpoints were 1.66 (95% CI = 1.22–2.10, p < 0.001) and 1.81 (95% CI = 1.42–2.20, p < 0.001), respectively. The between-group MD of I-QOL (ES: 0.74) at the primary and secondary endpoints were 16.50 (95% CI = 13.73–19.28, p < 0.001) and 17.48 (95% CI = 14.18–20.79, p < 0.001), respectively. The between-group MD of BRS (ES: 0.10) differed significantly between the active and sham rTMS groups at the primary (MD = 0.12, 95% CI = 0.20–0.22, p = 0.018) and secondary (MD = 0.25, 95% CI = 0.09–0.41, p = 0.002) endpoints. The cost-effectiveness (expressed as the cost-utility) study also identified a lower cost in the active rTMS group compared to the sham rTMS group. The active rTMS participants demonstrated positive experiences following the intervention.en_US
dcterms.abstractConclusion: Low-frequency rTMS is a promising therapeutic approach for addressing neurogenic OAB symptom severity among stroke survivors.en_US
dcterms.extentxlii, 520 pages : color illustrationsen_US
dcterms.isPartOfPolyU Electronic Thesesen_US
dcterms.issued2025en_US
dcterms.educationalLevelPh.D.en_US
dcterms.educationalLevelAll Doctorateen_US
dcterms.LCSHNeurogenic bladder -- Treatmenten_US
dcterms.LCSHBladder -- Diseases -- Treatmenten_US
dcterms.LCSHMagnetic brain stimulationen_US
dcterms.LCSHCerebrovascular disease -- Patientsen_US
dcterms.LCSHHong Kong Polytechnic University -- Dissertationsen_US
dcterms.accessRightsopen accessen_US

Files in This Item:
File Description SizeFormat 
8033.pdfFor All Users27.53 MBAdobe PDFView/Open


Copyright Undertaking

As a bona fide Library user, I declare that:

  1. I will abide by the rules and legal ordinances governing copyright regarding the use of the Database.
  2. I will use the Database for the purpose of my research or private study only and not for circulation or further reproduction or any other purpose.
  3. I agree to indemnify and hold the University harmless from and against any loss, damage, cost, liability or expenses arising from copyright infringement or unauthorized usage.

By downloading any item(s) listed above, you acknowledge that you have read and understood the copyright undertaking as stated above, and agree to be bound by all of its terms.

Show simple item record

Please use this identifier to cite or link to this item: https://theses.lib.polyu.edu.hk/handle/200/13585