Efficacy of combination of biofeedback therapy and pelvic floor muscle training in dyssynergic defecation

Background: It is now known that with appropriate exercises, the functions of the muscles in the body ameliorate and increase in strength. We applied pelvic floor muscle relaxation training and exercises that strengthen the abdominal and pelvic muscles in combination with biofeedback therapy (BFT) to patients with dyssynergic defecation (DD). Methods: Patients who met the criteria for DD and had no underlying organic cause were included in this study. The electromyography (EMG) technique was used for BFT therapy. Patients had received at least six sessions of BFT. BFT was considered successful in patients when the DD pattern in anorectal manometry (ARM) disappeared and/or adequate anal relaxation was obtained following BFT and in patients who had full clinical recovery. Results: Data of 104 patients (58 females [55.8%] and 46 males [44.2%]) was evaluated. Abdominal and rectal symptoms disappeared in 71 (68.26%) patients. Of the patients who achieved symptomatic improvement, 58 (55.76%) saw a disappearance of the dyssynergic defecation pattern. When the differences between anal sphincter pressures before and after treatment were compared in patients who responded to BFT and those who did not, no significant differences were observed, but significant changes were found in anal squeezing pressures. It was found that those who had high squeezing pressures before BFT, those who increased their squeezing pressures after BFT, and those who decreased their resting pressure responded better to BFT. Conclusions: In this study, BFT was found to be more effective in those with a high squeezing pressure and those that increased squeezing pressure after BFT. These findings will influence the treatment of patients with dyssynergic defecation who do not respond to treatment. A combination of abdominal and pelvic floor muscle exercises and BFT increases patient response.

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Pelvic-floor relaxation techniques using biofeedback – more effective therapy for chronic prostatitis/chronic pelvic pain syndrome

Journal of Clinical Urology ◽

10.1177/2051415820939450 ◽

2020 ◽

Vol 13 (6) ◽

pp. 454-459

Author(s):

Manish Pandey ◽

Vaibhav Shrivastava ◽

Vijay Patidar ◽

Sabby Dias ◽

Sameer Trivedi

Keyword(s):

Pelvic Floor ◽

Pelvic Pain ◽

Chronic Prostatitis ◽

Pelvic Floor Muscle ◽

Muscle Relaxation ◽

Chronic Pelvic Pain Syndrome ◽

Pain Syndrome ◽

Pelvic Pain Syndrome ◽

Group A ◽

Group B

Objective: Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is characterized by pelvic pain and voiding symptoms, the management of which is challenging. The present study was designed to assess the efficacy of biofeedback and pelvic-floor relaxation treatment for CP/CPPS. Methods: A total of 84 patients diagnosed with CP/CPPS were randomly assigned to one of the two groups: conventional therapy (group A) and pelvic-floor muscle relaxation and biofeedback (group B). The Biofeedback and Electrical Stimulation apparatus was used for pelvic-floor muscle electrical stimulation and relaxation with biofeedback. National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scores were evaluated at the start of therapy, after 3 months of treatment and at 6 months (3 months after last treatment received). Results: At 3 months, patients in both groups had a significant decrease (improvement in symptoms) in NIH-CPSI scoring. However, at 6 months, only 19 (47.5%) patients in group A maintained a fall in NIH-CPSI score >6 compared with 37 (94.8%) patients in group B ( p<0.05). At 6 months, there was significant decrease in NIH-CPSI score in group B, whereas in group A, scores had increased (worsening of symptoms). Conclusions: Pelvic-floor muscle relaxation and biofeedback training is a safe and effective treatment for CP/CPPS with sustained efficacy.

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Assessment of the strength of the pelvic floor musculature in women who practice Mat Pilates.

Manual Therapy Posturology & Rehabilitation Journal ◽

10.17784/mtprehabjournal.2014.12.178 ◽

2014 ◽

Vol 12 ◽

pp. 178

Author(s):

Marklana Da Frota Diniz ◽

Thiago Brasileiro De Vasconcelos ◽

Juliana Lerche Vieira Rocha Pires ◽

Marineide Meireles Nogueira ◽

Giselle Notini Arcanjo

Keyword(s):

Muscle Strength ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

The Body ◽

Abdominal Muscles ◽

Character Study ◽

Before And After ◽

Pilates Method ◽

Types Of Muscle Fibers

Introduction: The Pilates Method is a program of physical and mental training that works the body as a whole, aiming to gain muscle strength, mainly at the central region formed by the abdominal muscles, spine and pelvic floor, and to promote stretching and flexibility. Objective: To investigate the effects of this technique in the pelvic floor muscle activity, noting the type of fiber was more work during the practice of this activities in soil (Mat Pilates). Method: It was a character study of interventional, observational, descriptive, conducted during the months from March to May 2011, in which six women aged between 35 and 65 years, who underwent Mat Pilates classes twice a week, was rated the strength of pelvic floor, by Perina®perineometer pressure before and after the eight classes. Results: It was observed that all the volunteers had gained in strength in both types of muscle fibers, and 84% (p < 0.05) had greater gain in type 2 fibers. Conclusion: The Mat Pilates to increase the influence of the pelvic floor muscle strength it and can be used to prevent dysfunctions dysfunction of these muscles.

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Evaluation of flatulence of Uterus (Nafkhat-ol-rahem) as One of the Causes of Infertility in Women from the Viewpoint of Ali ibn Abbas Ahvazi and Modern Medicine

Journal of Contemporary Medical Sciences ◽

10.22317/jcms.v6i3.718 ◽

2020 ◽

Vol 6 (3) ◽

Author(s):

Fereshteh Golfakhabadi ◽

Zeinab Zaheri Abdevand ◽

Mojgan Tansaz

Keyword(s):

Pelvic Floor ◽

Traditional Medicine ◽

Pelvic Floor Muscle ◽

Muscle Relaxation ◽

Herbal Medicines ◽

Modern Medicine ◽

Vaginal Suppository ◽

The People ◽

Prevalent Disease ◽

Psychological Pressure

Objective: Today Infertility and its complications is one of the largest problems because it would impose economic burden and psychological pressure on the people. One of the infertility reasons in most Iranian Traditional medicine (ITM) manuscripts is focused on Nafkhat-ol-rahem. Methods: In this study, the Ibn Abbas theories in kamel al- Sina'ah about Nafkhat-ol-rahem, causes, reasons and treatment were investigated. To achieve recent studies, searches were performed in the databases with the keywords including vaginal flatus, vaginal flatulence and pelvic floor weakness. Results: This disease is caused by bad cold temper, hit and obstruction of cervix, etc. Traditional medicine considered the bloating of uterus (Nafkhat-ol-rahem) the cause of some miscarriages and infertility, because dense gas that accumulated in the uterus, preventing implantation and establishment of the embryo. In ITM, treatment involves the use of warm and mohallel riyah (gas dissolvent) herbal medicines in the form of oral, poultice (topical ointment), Forzajeh and Homol (vaginal suppository). Conclusion: Nafkhat-ol-Rahem is a highly prevalent disease in women, but because of the shame, the patient does not speak with her doctor. Bloating of uterus and vaginal flatulence seen in the pelvic floor muscle relaxation, which can be harmless or associated with major complications such as rectovaginal fistula and infection of the uterus.

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Effect of Postpartum Pelvic Floor Muscles Training in Pelvic Floor Muscles Strength on Postpartum Women with Stress Urinary Incontinence

Indonesian Journal of Obstetrics and Gynecology ◽

10.32771/inajog.v6i2.772 ◽

2018 ◽

pp. 114

Author(s):

Jerisatrio S Tarukallo ◽

David Lotisna ◽

Nugraha U Pelupessy

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Pelvic Floor Muscles ◽

P Value ◽

Postpartum Women ◽

Perineal Tear ◽

International Consultation ◽

Pelvic Floor Training ◽

Significant Difference ◽

Pelvic Muscles

Objective: To evaluate the effect of pelvic floor training (Kegelexercise) on pelvic floor muscle strength in postpartum womenwith SUI.Methods: Thirty-five birth vaginally postpartum women with SUIwere experimentally enrolled. After four weeks of postpartumobservation, the diagnosis of SUI confirmed, and all of these womenwere asked to complete the International Consultation onIncontinence Questionnaire-Sort Form (ICIQ-SF) questionnaire.The strength of the pelvic floor muscle measured with perineometerevery once in 3 weeks for 12 weeks of Kegel exercise. SUI severityassessed with ICIQ-SF after completing the Kegel exercise. A pairedt-test was used to compare measurement results between ICIQ-SFquestionnaire and perineometer and multiple linear regressionmodels was used for multivariate analysis. A p value of less than 0.05was taken to be statistically significant.Results: Findings show a significant difference between clinicalvariables (parity, neonates birth weight, perineal tear grade, BMI)and the improvement of pelvic floor muscles before and afterperformed the Kegel exercise (all p<0.05). The pelvic floormuscles strength significantly improved (p=0.000) after Kegelexercise both in ICIQ-SF questionnaire and perineometermeasurement.Conclusion: Pelvic muscles floor training or Kegel exercise improvepelvic muscles floor strength in postpartum women with SUI.[Indones J Obstet Gynecol 2018; 6-2: 114-118]Keywords: pelvic muscles floor training, postpartum, stress urinaryincontinence

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

Physical Therapy ◽

10.1093/ptj/82.8.798 ◽

2002 ◽

Vol 82 (8) ◽

pp. 798-811 ◽

Cited By ~ 5

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.

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Designing a Personalised Mobile Application to Improve Engagement With PFMT Therapy Amongst Women From Pregnancy To One Year After Delivery

10.26686/wgtn.17134298.v1 ◽

2021 ◽

Author(s):

◽

Mahkaila Jones

Keyword(s):

Pelvic Floor ◽

Mobile Application ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Effective Means ◽

Physical Symptoms ◽

Memory Time ◽

Pelvic Muscles ◽

One Year ◽

Knowledge Memory

Women who are pregnant, or have given birth are at high risk of developing Pelvic Floor Disorder (PFD) due to the physical stress placed on the pelvic muscles during this time. When left untreated, PFD can cause symptoms such as incontinence, organ prolapse and pelvic pain in sufferers. Pelvic Floor Muscle Training (PFMT) is a highly effective means of treating and preventing symptoms of PFD. However, adherence rates to PFMT remain low. Amongst the biggest barriers to adherence are incorrect technique, lack of knowledge, memory, time, low motivation and stigma. As with the physical symptoms of PFD, these barriers impact sufferers in ways unique to each individual. Findings from the existing literature suggest that personalising the intervention to accommodate these varying factors may improve adherence. This study focuses on the development of a personalised mobile application to improve engagement with PFMT amongst women from pregnancy, up to one year after delivery. The goal of the application is to improve engagement with PFMT through addressing key barriers to adherence, and guiding correct performance of PFMT. An initial design criteria and five user personas were developed. The criteria and personas were used to develop prototypes, which were then user tested. The designs were then refined based on user feedback. Designs were also informed by feedback from interviews with clinicians and women. The results of this study indicate that a mobile application is an ineffective means of guiding PFMT technique. However the application proved effective in addressing the barrier of memory through the use of context based triggers. The integration of the Hooked model in the application design had a low to moderate effect on improving engagement with PFMT. Opportunities for a personalised design approach in the areas of instruction, facilitation of exercises and preferences for application features were identified.

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Utilising Synergism Between the Transverse Abdominal and Pelvic Floor Muscles at Different Postures in Nulliparous Women: a Randomized Case Control Study

10.21203/rs.3.rs-153944/v1 ◽

2021 ◽

Author(s):

Tímea Molnár ◽

Andrea Domján ◽

Mónika Szűcs ◽

Andrea Surányi ◽

József Bódis

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Abdominal Muscle ◽

Pelvic Floor Muscles ◽

The Body ◽

Rank Test ◽

Urinary Leakage ◽

Nulliparous Women ◽

Dynamic Endurance ◽

And Control

Abstract Background: To determine the effects of the pelvic floor muscle training (PFM-T) in combination with transverse abdominal muscle (TRA) activation (cPFM-T) in female urinary incontinence.Methods: We enrolled nulliparous women in supine (SUG) (n = 22), sitting (SIG) (n = 19) and control (COG) (n = 14) groups. We performed the 8-week cPFM-T programme. We examined the effect of training on the parameters with the Kruskal–Wallis test, and the pairwise comparisons with the Mann-Whitney U-test and the Wilcoxon-rank test with the Bonferroni correction.Results: Before training, 15 participants reported occasional urinary leakage. After cPFM-T seven participants reported that urinary leakage had disappeared. Maximal isometric contraction of the pelvic floor muscles (PFM) until fatigue improved significantly in the SUG (p < 0.001) and SIG (p = 0.015) and not significantly in the COG (p = 0.499). Holding time increased in the SUG (p = 0.972) and the SIG (p = 0.717), and decreased in the COG (p = 0.132). The dynamic endurance of the PFM improved significantly in the SUG (p < 0.001), but not in the SIG (p = 0.798) and the COG (p = 0.153). The number of maximal fast contractions within 1 minute increased in both the SUG (p < 0.001) and the SIG (p=0.813) and decreased in the COG (p = 0.257). Relaxation improved significantly in the SIG (p = 0.011). TRA thickness increased in both training groups.Conclusions: Slow-twitch fibres of the PFM can be trained effectively with PFM-T in both the body positions.Trial registration: This study was registered in the Hungarian National Healthcare Service Center: 019234/2014/OTIG Registered 07 April 2014 modification: 096623-002/2015/OTIG Registered 11 November 2015 https://www.aeek.huThe study was retrospectively registered in ClincalTrials.gov NCT04577872 Registered 22 September 2020. https:// https://clinicaltrials.gov

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Utilizing Synergism between the Transverse Abdominal and Pelvic Floor Muscles at Different Postures in Nulliparous Women: A Randomized Case-Control Study

Urologia Internationalis ◽

10.1159/000519590 ◽

2021 ◽

pp. 1-8

Author(s):

Tímea Molnár ◽

Andrea Domján ◽

Mónika Szűcs ◽

Andrea Surányi ◽

József Bódis

Keyword(s):

Pelvic Floor ◽

Muscle Activation ◽

Pelvic Floor Muscle ◽

The Body ◽

Rank Test ◽

Urinary Leakage ◽

Nulliparous Women ◽

Slow Twitch ◽

Dynamic Endurance ◽

And Control

Introduction: The aim of the study was to determine the effects of the pelvic floor muscle (PFM) training (PFM-T) in combination with transverse abdominal (TRA) muscle activation (cPFM-T) in female urinary incontinence. Methods: We enrolled nulliparous women in supine (SUG) (n = 22), sitting (SIG) (n = 19), and control (COG) (n = 14) groups. We conducted an 8-week cPFM-T programme. We examined the effect of training on the parameters with the Kruskal-Wallis test, the pairwise comparisons with the Mann-Whitney U test, and the Wilcoxon rank test with the Bonferroni correction. Results: Before training, 15 participants reported occasional urinary leakage. After cPFM-T, 7 participants reported that urinary leakage had disappeared. Maximal isometric contraction of the PFMs until fatigue improved significantly in the SUG (p < 0.001) and SIG (p = 0.015) groups but not significantly in the COG group (p = 0.499). Holding time increased in the SUG (p = 0.972) and the SIG (p = 0.717) groups and decreased in the COG group (p = 0.132). The dynamic endurance of the PFM improved significantly in the SUG group (p < 0.001) but not in the SIG (p = 0.798) and the COG (p = 0.153) groups. The number of maximal fast contractions within 1 min increased in both the SUG (p < 0.001) and SIG (p = 0.813) groups and decreased in the COG group (p = 0.257). Relaxation improved significantly in the SIG group (p = 0.011). TRA mucle thickness increased in both training groups. Conclusion: Slow-twitch fibres of the PFM can be trained effectively with PFM-T in both the body positions.

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

Central Asian Journal of Medical Hypotheses and Ethics ◽

10.47316/cajmhe.2021.2.2.06 ◽

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.

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Proposal of a protocol for pelvic floor muscle evaluation and training to provide care to women with urinary incontinence

Revista da Escola de Enfermagem da USP ◽

10.1590/s1980-220x2019033503705 ◽

2021 ◽

Vol 55 ◽

Author(s):

Gisela Maria Assis ◽

Camilla Pinheiro Cristaldi da Silva ◽

Gisele Martins

Keyword(s):

Urinary Incontinence ◽

Pelvic Floor ◽

Pelvic Floor Muscle ◽

Muscle Coordination ◽

Unified Health System ◽

Care Protocol ◽

Pelvic Muscles ◽

Nursing Diagnoses ◽

And Training ◽

Training Protocol

ABSTRACT Objective: To present a proposal of a protocol for pelvic floor muscle evaluation and training to provide care to women with urinary incontinence. Method: Professional experience report, conducted in an outpatient facility for voiding dysfunctions in the Brazilian Unified Health System, conducted by an enterostomal therapist nurse. Results: Elaboration of a proposal of care protocol in nursing consultations based on a directed physical examination, nursing diagnoses of the International Classification for Nursing Practice, and the adaptation of a muscle training protocol as prescription. Steps: static observation, dynamic observation, and palpation to verify the tension and evaluation of strength, sustentation, relaxation, and muscle coordination, followed by prescriptions for relaxation, proprioception, training for strength, sustentation, abdominal and pelvic coordination, and maintenance, as per diagnosis. Conclusion: This protocol proposal intends to support the evaluation of the pelvic muscles of women with urinary incontinence or at risk for developing this condition by nurses of all levels of healthcare, especially as part of nursing consultations in primary care.

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