Efficacy of diadynamic currents versus transcutaneous electrical nerve stimulation for transcutaneous tibial nerve stimulation in subjects with overactive bladder syndrome: A double-blind randomized controlled trial

BACKGROUND: In the traditional treatment of overactive bladder (OAB) with transcutaneous posterior tibial nerve stimulation (TTNS), physical therapists currently use only transcutaneous electrical nerve stimulation (TENS). However, the literature has commonly replaced TENS with diadynamic currents for various musculoskeletal pain syndromes. Moreover, no literature describes the use of diadynamic currents in the TTNS procedure. Therefore, our study aimed to determine the efficacy of diadynamic currents (DDC) versus TENS for TTNS in OAB Treatment. METHODOLOGY: A randomized controlled trial was conducted among female patients with OAB aged 18-80 years. Subjects were randomly allocated to control and experimental groups. Participants in the control group received TTNS with TENS, and those in the experimental group underwent TTNS using DDC. Both groups received 8 TTNS sessions, two per week for 4 weeks. We measured pre- and post-intervention improvements using the International Consultation on Incontinence Questionnaire (ICIQ) for OAB and the ICIQ OAB Quality of Life (QOL). The study is registered with the Clinical Trials Registry of India under registration number CTRI/2025/12/099269. RESULTS: The mean age of the included sample was 59.75 years. Pre- and post-intervention ICIQ-OAB and ICIQ-OAB QOL scores showed significant improvements in disease symptoms and quality of life among patients with OAB in both the control and experimental groups. Comparison of improvements between the two groups on the ICIQ questionnaires showed no significant difference (p-values of 0.87 and 0.95). Correlations between patient-related characteristics and improvements in outcome measures were also not significant. CONCLUSION: Eight sessions of TENS and DDC, combined with conventional physical therapy, including Kegel and breathing exercises, can reduce OAB symptoms and improve QOL in subjects with OAB syndrome. Diadynamic current can be used as an adjunct to conventional TENS in TTNS for treating OAB syndrome.