scholarly journals The Effects of a Progressive Exercise Program With Surface Electromyographic Biofeedback on an Adult With Fecal Incontinence

2002 ◽  
Vol 82 (8) ◽  
pp. 798-811 ◽  
Author(s):  
Stephanie Weiss Coffey ◽  
Elaine Wilder ◽  
Michael J Majsak ◽  
Renee Stolove ◽  
Lori Quinn
Keyword(s):  
Physical Therapy ◽  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Relaxation Training ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Muscles ◽  
Vacuum Extraction ◽  
Physical Relationship ◽  
Electromyographic Biofeedback ◽  
Patient Reported

AbstractBackground and Purpose. Fecal incontinence often compromises a person's ability to participate in work and recreational activities. Incontinence may also diminish a person's willingness to take part in social events, leading to feelings of isolation. This case report describes physical therapy designed to reduce a patient's pelvic-floor muscle dysfunction and fecal incontinence. Case Description. The patient was a 30-year-old woman whose fecal incontinence began after the complicated vaginal birth of her first child that required a vacuum extraction and episiotomy. Intervention included soft tissue techniques, electromyographic biofeedback, strength training, relaxation training, patient education, and a home program. The patient completed a questionnaire at initial evaluation and at discharge to assess her perceived limitations in functional activities. Electromyographic analysis was used to measure changes in the patient's pelvic-floor muscle control. Outcomes. The social, occupational, and sexual domains, which the patient initially judged to be the most compromised, showed the greatest improvement. Electromyographic data for the final treatment session indicated improved strength, endurance, and control of her pelvic-floor muscles. The patient reported no episodes of fecal incontinence over the last month of the 3 months of therapy. Discussion. The physical therapy program may have led to improved bowel continence and greater control of the pelvic-floor muscles, resulting in greater confidence and comfort in social and work situations and less restriction in the patient's physical relationship with her spouse.

scholarly journals PELVIC FLOOR MUSCLE EXERCISE AND PHYSICAL THERAPY MAY IMPROVE SYSTEMIC SCLEROSIS-ASSOCIATED FECAL INCONTINENCE

2021 ◽  
Vol 2 (2) ◽  
pp. 104-108
Author(s):  
Neslihan Gokcen
Keyword(s):  
Systemic Sclerosis ◽  
Physical Therapy ◽  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Treatment Strategies ◽  
Muscle Exercise ◽  
Biofeedback Therapy ◽  
Gastrointestinal Complications ◽  
Pelvic Floor Muscle Exercise

Gastrointestinal involvement in systemic sclerosis (SSc) is observed in up to 90% of patients. Resolution of some of these gastrointestinal complications is challenging without the support of physical therapy and rehabilitation. One of these complications, SSc-associated fecal incontinence, which can be devastating for those affected, is seen in up to 39%. Studies focusing on fecal incontinence and its treatment are scarce. The hypothesis presented herein suggests that pelvic floor muscle exercise, biofeedback therapy, and neuromodulation methods might be effective and safe treatment strategies for patients affected by this debilitating complication.

scholarly journals Biofeedback for Pelvic Floor Disorders

2020 ◽  
Author(s):  
Melissa Hite ◽  
Thomas Curran
Keyword(s):  
Physical Therapy ◽  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Disorders ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
The Body ◽  
Muscle Training ◽  
Low Anterior Resection Syndrome ◽  
Anorectal Pain

AbstractDefecatory disorders can include structural, neurological, and functional disorders in addition to concomitant symptoms of fecal incontinence, functional anorectal pain, and pelvic floor dyssynergia. These disorders greatly affect quality of life and healthcare costs. Treatment for pelvic floor disorders can include medications, botulinum toxin, surgery, physical therapy, and biofeedback. Pelvic floor muscle training for pelvic floor disorders aims to enhance strength, speed, and/or endurance or coordination of voluntary anal sphincter and pelvic floor muscle contractions. Biofeedback therapy builds on physical therapy by incorporating the use of equipment to record or amplify activities of the body and feed the information back to the patients. Biofeedback has demonstrated efficacy in the treatment of chronic constipation with dyssynergic defecation, fecal incontinence, and low anterior resection syndrome. Evidence for the use of biofeedback in levator ani syndrome is conflicting. In comparing biofeedback to pelvic floor muscle training alone, studies suggest that biofeedback is superior therapy.

scholarly journals Electrostimulation, response of the pelvic floor muscles, and urinary incontinence in elderly patients post prostatectomy

2014 ◽  
Vol 27 (1) ◽  
pp. 93-100
Author(s):  
Patrícia Zaidan ◽  
Elirez Bezerra da Silva
Keyword(s):  
Urinary Incontinence ◽  
Electrical Stimulation ◽  
Physical Therapy ◽  
Radical Prostatectomy ◽  
Pelvic Floor ◽  
Pelvic Floor Muscles ◽  
Significance Level ◽  
Electromyographic Biofeedback ◽  
Before And After ◽  
Rest Time

Objective to investigate the response of the pelvic floor muscles (PFM), and urinary incontinence (UI), in patients having undergone a prostatectomy, after treatment using electrical stimulation. Materials and methods this observational study was conducted in an outpatient urogynecologic physical therapy clinic of Hospital dos Servidores in Rio de Janeiro, Brazil from August to September 2012. Ten patients (aged, 64 ± 7 years) with urinary incontinence resulting from radical prostatectomy, having received surgery within six months of study entry, without urinary infection, and without metallic implants underwent electrical stimulation of the PFM, while in lateral decubitus position with knees and hips flexed. The parameters used were 65 Hz frequency, pulse width of 500 µs, biphasic current, intensity according to the tolerance level reported by the patient, perineal contraction time of four seconds, and rest time of eight seconds for 20 minutes twice a week, totaling 16 sessions of electrical stimulation with active-assisted contraction. Patients were evaluated before and after electrical stimulation through physical therapy evaluation of urinary incontinence, by being asked about the number of disposable guards used daily, using a visual analogue scale (VAS) to measure how the UI interfered with activities of daily living, and by electromyographic biofeedback to measure the work of the PFM. Data were analyzed using Student’s paired t-tests and a significance level of 0.05. Results after 16 sessions of electrical stimulation, the electromyographic biofeedback evaluation showed a significant increase in muscle strength of 10.73 ± 8.64 to 17.16 ± 9.00 µV (t = -3.39, P = 0.008), a significant decrease in the number of diapers used before and after treatment (3.9 ± 1.2 to 1.8 ± 1.5, respectively; t = 5.16, P = 0.0006), and a significant decrease in the interference of urinary incontinence on daily activities of 9.6 ± 0.5 to 4.0 ± 3.8 (t = 5.15, P = 0.0006). Conclusion electrical stimulation may represent a novel way to strengthen the pelvic floor muscles and decrease urinary incontinence resulting from radical prostatectomy.

scholarly journals Pelvic floor muscle training for women with pelvic organ prolapse: the PROPEL realist evaluation

2020 ◽  
Vol 8 (47) ◽  
pp. 1-104
Author(s):  
Margaret Maxwell ◽  
Karen Berry ◽  
Sarah Wane ◽  
Suzanne Hagen ◽  
Doreen McClurg ◽  
...  
Keyword(s):  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Symptom Score ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Pelvic Organ ◽  
Realist Evaluation ◽  
Muscle Training ◽  
Patient Reported ◽  
Study Sites

Background Pelvic organ prolapse is estimated to affect 41–50% of women aged > 40 years. A multicentre randomised controlled trial of individualised pelvic floor muscle training found that pelvic floor muscle training was effective in reducing symptoms of prolapse, improved quality of life and showed clear potential to be cost-effective. Provision of pelvic floor muscle training for prolapse has continued to vary across the UK, with limited availability of specialist physiotherapists to deliver it. Objectives This project aimed to study the implementation and outcomes of different models of delivery to increase the service provision of pelvic floor muscle training, and to follow up treatment outcomes for the original trial participants. Design A realist evaluation of pelvic floor muscle training implementation conducted within three full case study sites and two partial case study sites; an observational prospective cohort study comparing patient-reported outcomes pre and post intervention in all five sites; and a long-term follow-up study linking previous trial participants to routine NHS hospital data. Setting The setting for the realist evaluation was pelvic floor muscle training service delivery models in three NHS sites. The setting for the patient-reported outcome measures study was pelvic floor muscle training services in five NHS sites. Methods Realist evaluation qualitative data were collected at four time points in three case study sites to understand the implementation models, uptake, adherence and impact. Interviews involved service managers/leads, consultants, staff delivering pelvic floor muscle training and women receiving pelvic floor muscle training. Main outcomes measures Patient-reported outcomes were collected at baseline and at 6 and 12 months across five sites, including the Pelvic Organ Prolapse Symptom Score, health-related quality of life (measured using the EuroQol-5 Dimensions, five-level version, questionnaire), prolapse severity (measured using the Pelvic Organ Prolapse Quantification System), urinary incontinence (measured using International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form) and need for further treatment. Results A total of 102 women were recruited to the patient-reported outcome measures cohort study (target, n = 120), and 65 women had matched baseline and 6-month Pelvic Organ Prolapse Symptom Scores. The mean Pelvic Organ Prolapse Symptom Score was 10.18 (standard deviation 5.63) at baseline and 6.98 (standard deviation 5.23) at 6 months, representing a statistically significant and clinically meaningful difference. There was no statistically significant difference between the outcomes obtained from delivery by specialist physiotherapists and the outcomes obtained from delivery by other health-care professionals (mean change in Pelvic Organ Prolapse Symptom Score: –3.95 vs. –2.81, respectively). Services delivered using higher-band physiotherapists only were more costly than services delivered using other staff mixes. The effect of the original pelvic floor muscle training intervention, over a post-intervention period of > 10 years, was a reduction in the odds of any treatment during follow-up (odds ratio 0.61, 95% confidence interval 0.37 to 0.99). The realist evaluation revealed stark differences in implementation. The site with a specialist physiotherapy service resisted change because of perceived threats to the specialist role and concerns about care quality. Pelvic floor muscle training delivery by other health-care staff was easier when there was a lack of any existing specialist service; staff had prior training and interest in pelvic health; staff had support, autonomy, time and resources to deliver pelvic floor muscle training as part of their core role; and surrounding services supported a flow of pelvic floor muscle training referrals. Limitations The number of available matched pre and post outcomes for women and the lack of Pelvic Organ Prolapse Quantification System examinations were limitations of this study. Conclusions It is possible to train different staff to effectively deliver pelvic floor muscle training to women. Women’s self-reported outcomes significantly improved across all service models. Training should be adequately tailored to differential skill mix needs. Future work Future work should include further implementation of pelvic floor muscle training and should include pre- and post-outcome data collection using the Pelvic Organ Prolapse Symptom Score. Study registration This study is registered as Research Registry 4919. Funding This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research; Vol. 8, No. 47. See the NIHR Journals Library website for further project information.

The role of pelvic floor muscles in fecal incontinence

2000 ◽  
Vol 118 (4) ◽  
pp. A126
Author(s):  
Jose Fraga ◽  
Fernando Azpiroz ◽  
Juan -R Malagelada
Keyword(s):  
Fecal Incontinence ◽  
Pelvic Floor ◽  
Pelvic Floor Muscles

2. VAGINISMUS, VULVODYNIA AND PELVIC FLOOR MUSCLE ACTIVITY

Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 285
Author(s):  
R. Sapsford
Keyword(s):  
Pelvic Floor ◽  
Muscle Activity ◽  
Pelvic Floor Muscle ◽  
Normal Function ◽  
Pelvic Floor Muscles ◽  
Abdominal Pressure ◽  
Abdominal Muscles ◽  
Physiological Factors ◽  
Muscle Groups ◽  
Postural Support

The pelvic floor muscles form the base of the abdominal cylinder and work in synergy with other muscles around the cylinder - the abdominal muscles and the diaphragm. Activity in each muscle group affects the others. Coordinated recruitment of these muscle groups is necessary for generation and maintenance of intra-abdominal pressure, postural support of the trunk, and during functional tasks such as lifting, coughing and nose blowing. Coordinated release of these groups is required for micturition, while defaecation may need activity in some muscles and release in others. Vaginismus and vulvodynia both have a component of over activity of the pelvic floor muscles which impairs normal function, though this over activity may only occur at the time of attempted penetration. Some of the physiological factors that contribute to this overactivity come from outside the pelvic floor muscle complex itself and can be ameliorated by understanding and management of these muscle synergies. An EMG study of muscle activity of the abdominal and pelvic floor muscles during a simulated body posturing for female sexual arousal will help to explain how the pelvic floor muscle over activity in vaginismus arises. Treatment programmes that have been used to successfully address these problems will be explained.

Biofeedback for Pelvic Muscle Dysfunction

Biofeedback ◽  
2016 ◽  
Vol 44 (2) ◽  
pp. 55-57
Author(s):  
Debbie Callif
Keyword(s):  
Pelvic Floor ◽  
Pelvic Pain ◽  
Control Strategies ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Bowel Function ◽  
Pelvic Floor Muscles ◽  
Muscle Dysfunction ◽  
Reduction Techniques ◽  
Obturator Internus

Biofeedback for pelvic floor muscle dysfunction provides a practical and effective intervention for elimination disorders. Dysfunction in the pelvic floor muscles can affect bladder and bowel function and can cause pelvic pain. According to the National Association of Continence, there are 25 million Americans affected by bladder or bowel incontinence. Surface electromyographic (sEMG) sensors monitor the electrical activity of the pelvic floor muscles. Additional muscle co-contractions of the obturator internus, hip adductors, and transverse abdominis can facilitate improvements in symptoms affected by pelvic floor dysfunction. Pelvic floor therapy incorporates urge reduction techniques and functional control strategies. Dietary and lifestyle recommendations are also provided. The Biofeedback Certification International Alliance (BCIA) is the primary certifying body in the fields of biofeedback and neurofeedback. BCIA has a Blueprint of Knowledge specific for certification in pelvic muscle dysfunction biofeedback (PMDB). The Blueprint outlines the fundamental science, history, and theory of sEMG biofeedback as used for elimination disorders and chronic pelvic pain. You can find more information on PMDB at www.bcia.org.

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