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.

Ultrasonic Diagnosis and Analysis of the Effect of Labor Analgesia on Early Pelvic Floor Function and Pelvic Floor Dysfunction

2021 ◽  
Vol 11 (7) ◽  
pp. 1903-1910
Author(s):  
Xiaolan Wang ◽  
Fan Yang ◽  
Wenjuan Chen ◽  
Xiaohong Yuan
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Pelvic Floor Muscles ◽  
Labor Analgesia ◽  
Natural State ◽  
Levator Ani Muscle ◽  
Pelvic Floor Function ◽  
Floor Function

Pelvic floor dysfunction disease (PFD) is a common pelvic organ dysfunction disease in the clinic of obstetrics and gynecology. Its cause is mainly the damage, defects and dysfunction of the pelvic floor support structure. Not only is the pathogenesis complicated, but also various symptoms coexist, which seriously affects the physical and mental health of female patients. Mechanical injury of the pelvic floor fascia tissue and levator ani muscles is the anatomical basis of PFD after birth; early postpartum pelvic floor examination and treatment can prevent and control the occurrence or development of PFD. Spinal canal anesthesia has good analgesic effect during labor and delivery, has little effect on mothers and infants, and is widely used. However, there are few domestic and foreign reports on the effect of labor analgesia on the pelvic floor. Labor analgesia relaxes the pelvic floor muscles, unblocks the birth canal, and the influence on the pelvic floor muscles is worth exploring. Based on the pelvic floor muscle strength screening to understand the changes in the function of the pelvic floor muscles, combined with the three-dimensional pelvic floor ultrasound examination, the pelvic floor structure and the levator ani muscle are clearly imaged, and the pelvic floor muscle structure is evaluated in the natural state and the analgesic muscle relaxation state. This study used a combination of the two to evaluate the effect of labor analgesia on pelvic floor function of primiparous women; provide individualized intervention treatment for high-risk groups screened; provide clinical basis for the prevention and treatment of PFD.

scholarly journals Predictors of Pelvic Floor Muscle Dysfunction Among Women With Lumbopelvic Pain

2019 ◽  
Vol 99 (12) ◽  
pp. 1703-1711 ◽  
Author(s):  
Alexzandra Keizer ◽  
Brittany Vandyken ◽  
Carolyn Vandyken ◽  
Darryl Yardley ◽  
Luciana Macedo ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Central Sensitization ◽  
Pelvic Floor Muscle ◽  
Cross Sectional Study ◽  
Clinical Findings ◽  
Self Report ◽  
Muscle Dysfunction ◽  
Cross Sectional ◽  
Obturator Internus ◽  
Muscle Tenderness

Abstract Background There is evidence to suggest that a large proportion of individuals seeking care for lumbopelvic pain also have pelvic floor muscle dysfunction (PFMD). Because the majority of physical therapists do not have the requisite training to adequately assess pelvic floor musculature, determining predictors of PFMD could be clinically useful. Objective The objective was to establish a combination of factors (self-report and physical) predictive of PFMD in women with lumbopelvic pain. Design This was a cross-sectional study. Methods Participants completed a battery of self-report and physical assessments (masked assessors). Three clinical findings characterized PFMD: weakness of the pelvic floor, lack of coordination of the pelvic floor, and pelvic floor muscle tenderness on palpation (bilateral obturator internus). Univariate and multivariate logistic regression analyses were used to determine the extent to which different predictors were associated with PFMD. Results One hundred eight women with self-reported lumbopelvic pain (within the past week) were included in the study (mean age = 40.4 years; SD = 12.6 years). None of the examined factors predicted pelvic floor muscle weakness. Two factors independently predicted pelvic floor muscle tenderness on palpation: very strong and/or uncontrollable urinary urges (odds ratio [OR] = 2.93; 95% confidence interval [CI] = 1.13–7.59) and Central Sensitization Inventory scores of 40 or greater (OR = 3.13; 95% CI = 1.08–9.10). Limitations The sample consisted of young women, some of whom were not actively seeking care. Additionally, the technique for assessing pelvic floor muscle tenderness on palpation requires further validation. Conclusions Women who have lumbopelvic pain, uncontrollable urinary urgency, and central sensitization were, on average, 2 times more likely to test positive for pelvic floor muscle tenderness on palpation. Further studies are needed to validate and extend these findings.

scholarly journals Effectiveness of Exercise Interventions on Pelvic Floor Muscle Function of Pregnant and Postpartum Women: A Systematic Review of Reviews

2021 ◽  
Author(s):  
Iina Ryhtä ◽  
Anna Axelin ◽  
Lotta Hamari
Keyword(s):  
Pelvic Floor ◽  
Pelvic Pain ◽  
Muscle Function ◽  
Pelvic Floor Muscle ◽  
Postnatal Period ◽  
Pelvic Floor Muscles ◽  
Postpartum Women ◽  
Low Back ◽  
Exercise Interventions ◽  
Review Of Reviews

Abstract BackgroundDysfunctions related to pelvic floor muscles such as urinary incontinence and pelvic pain are common among pregnant and postpartum women. With properly functioning pelvic floor muscles, it is possible to prevent these dysfunctions. Still, shared understanding about effective exercise interventions is missing. The aim of this review of reviews was to form a summary of the existing evidence about effective exercise interventions on pelvic floor muscle function of pregnant and postpartum women. MethodsNine databases were searched by June 12, 2020. PICO was used to define the eligibility criteria. Population: pregnant or postpartum women, interventions: activity-based interventions aiming to affect the function of pelvic floor muscles, comparators: waiting list or usual care, outcomes: disorders concerning pelvic floors muscles, study design: systematic reviews and meta-analysis. Screening and quality assessment were conducted by two researchers separately. The data were extracted and analyzed narratively. ResultsAltogether 20 systematic reviews reporting findings from 147 original studies were included. The methodological quality of the included reviews was mainly good, overall scores varying from 6/11–11/11. The results showed it may be possible to reduce low-back and pelvic pain as well as the severity of pain with exercise interventions during pregnancy but no association with odds of low back and pelvic pain during the postpartum period were found. With prenatal exercise interventions, it is possible to decrease the risk of urinary incontinence during pregnancy and the postnatal period, but the differences between the control group and the intervention group seem to vanish in the late postnatal period. The results were carefully optimistic within postnatal exercise interventions that decreased pelvic pain, reduction in vaginal bulging and pelvic organ prolapse, but more research is needed. ConclusionsOverall, the level of evidence was low. It seems that with exercise interventions it could be possible to prevent and provide care for the disorders of pelvic floor muscles to some extent. However, more high-quality research is needed to support decision making in the health care systems and to get evidence-based knowledge guiding health professionals working with pregnant and postpartum women.

Possibilities of using neodymium laser (Nd:YAG) in patients with concomitant diseases which are accompanied by pathological discharge from the genital tract

GYNECOLOGY ◽  
2020 ◽  
Vol 22 (4) ◽  
pp. 75-81
Author(s):  
Olga A. Pauzina ◽  
Inna A. Apolikhina ◽  
Darya A. Malyshkina
Keyword(s):  
Drug Therapy ◽  
Pelvic Floor ◽  
Genital Tract ◽  
Vaginal Discharge ◽  
Muscle Tone ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Vaginal Wall ◽  
Neodymium Laser ◽  
Frequent Relapses

Background. Pathological vaginal discharge is the most common disorder in women after giving birth who have vaginal relaxation syndrome and vaginal wall prolapse, as well as in women during menopause. To date, there are no clear treatment regimens for mixed vulvovaginal infections, and the use of only drug therapy in patients with pelvic organ prolapse and genitourinary syndrome of menopause in combination with diseases which are accompanied by pathological vaginal discharge does not give a long lasting result and is characterized by frequent relapses. In this regard, the use of laser methods in combination with drug therapy may lead to the recovery of vaginal microbiocenosis and a decrease in the number of relapses of diseases which are accompanied by pathological discharge from the genital tract. Results. Description. This article presents a clinical case and description of the experience of using a neodymium laser for the treatment of a patient with recurrent mixed vulvovaginitis, 2nd- degree vaginal wall prolapse, loss of pelvic floor muscle tone, vaginal relaxation syndrome and sexual dysfunction using neodymium laser. The woman received 3 procedures of exposure to a neodymium laser with an interval of 2830 days. After 3 procedures of exposure to a neodymium laser, the patient has a good clinical efficacy in the recovery of vaginal microbiocenosis. Conclusions. An innovative technique of exposure to Nd:YAG neodymium laser in the practice of a gynecologist has shown high clinical efficiency in the treatment of not only pelvic floor dysfunction, but also mixed vulvovaginitis. And, despite this aspect of the use of laser technologies requires further study, we can use a neodymium laser in combination with traditional drug therapy to treat diseases which are accompanied by pathological discharge from the genital tract in cases of ineffective drug monotherapy and frequent relapses.

scholarly journals Episiotomy: the biomechanical impact of multiple small incisions during a normal vaginal delivery

2019 ◽  
Vol 9 (5) ◽  
pp. 20190027 ◽  
Author(s):  
Dulce Oliveira ◽  
Maria Vila Pouca ◽  
João Ferreira ◽  
Teresa Mascarenhas
Keyword(s):  
Pelvic Floor ◽  
Pelvic Floor Dysfunction ◽  
Levator Ani ◽  
Symphysis Pubis ◽  
Pelvic Floor Muscles ◽  
Point Of View ◽  
Normal Vaginal Delivery ◽  
Tissue Integrity ◽  
Levator Trauma ◽  
Reaction Forces

Childbirth-related injuries are one of the main causes of pelvic floor dysfunction. To attempt to avoid serious tears during delivery, an episiotomy can be performed. In this study, we intended to investigate the biomechanical performance of the pelvic floor muscles after performing different episiotomies using a physics-based computational model which includes the pelvic floor muscles and the fetus. Previous biomechanical studies have analysed the mechanical effects of single incisions of different lengths; in this study, we intend to analyse the implications of multiple small incisions, evaluating the reaction forces, the stress on the muscles and the loss of tissue integrity sustained by the pelvic floor. The obtained results predict that an episiotomy delivery reduces the likelihood of macroscopic levator trauma by decreasing the stress on the region of insertion of the rectal area of the levator ani in the symphysis pubis . From the mechanical point of view, multiple incisions do not bring benefits compared to larger incisions. However, nothing can be ascertained about the clinical benefit of such an approach.

scholarly journals Arabic translation, cultural adaptation, and validation of Australian Pelvic Floor Questionnaire in a Saudi population

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haifaa Malaekah ◽  
Haifaa Saud Al Medbel ◽  
Sameerah Al Mowallad ◽  
Zahra Al Asiri ◽  
Alhanouf Albadrani ◽  
...  
Keyword(s):  
Pelvic Floor ◽  
Cultural Adaptation ◽  
Pelvic Floor Dysfunction ◽  
Bowel Function ◽  
Internal Consistency Reliability ◽  
Bladder Function ◽  
Arabic Version ◽  
Saudi Population ◽  
Prolapse Symptoms ◽  
Pelvic Floor Questionnaire

Abstract Introduction and hypothesis The aims of the study were the translation, cultural adaptation, and validation of self-administered Australian Pelvic Floor Questionnaire (APFQ) on a Saudi population. Methods The translation and cultural adaptation was performed in 854 women over 18 and not pregnant who agreed to answer the Arabic version of the questionnaire. The content/face validity, internal consistency (reliability), and construct validity (factor analysis) were assessed. Statistical analysis was carried out using SPSS 24.0 statistical software. Results The Cronbach’s alpha results were above 0.8 for the questionnaire’s overall reliability (bladder function: 0.877, bowel function: 0.834, prolapse symptoms: 0.784, sexual function: 0.762) showing adequate internal consistency reliability and high statistical significance. A statistically significant correlation was observed among the 40 items of the questionnaire. The issue of multicollinearity was not found, and the determinant of the correlation matrix was 0.001. A value of > 0.5 was achieved when the Kaiser–Meyer–Olkin and Bartlett’s tests measured 0.806 and the Bartlett’s test of sphericity was statistically significant χ2 (780) = 4150.46 (p < 0.001). The values of loading indicate that all 4 factors (bladder function, bowel function, prolapse symptoms, sexual function) contributed to each of their items. Conclusions This study provides the Arabic version of the self-administered APFQ as a reliable and valid instrument for evaluating symptom severity and impact of pelvic floor dysfunction on the quality of life of Arabic women. It also will enable the researchers from Arab countries to use this instrument to assess pelvic floor dysfunction prevalence in their settings.

scholarly journals Pelvic-Floor Dysfunction Prevention in Prepartum and Postpartum Periods

Medicina ◽  
2021 ◽  
Vol 57 (4) ◽  
pp. 387
Author(s):  
Karolina Eva Romeikienė ◽  
Daiva Bartkevičienė
Keyword(s):  
Clinical Trials ◽  
Pelvic Organ Prolapse ◽  
Pelvic Floor ◽  
Randomized Clinical Trials ◽  
Pelvic Floor Muscle Training ◽  
Pelvic Floor Muscle ◽  
Pelvic Floor Dysfunction ◽  
Pelvic Organ ◽  
Cochrane Library ◽  
Muscle Training

Every woman needs to know about the importance of the function of pelvic-floor muscles and pelvic organ prolapse prevention, especially pregnant women because parity and labor are the factors which have the biggest influence on having pelvic organ prolapse in the future. In this article, we searched for methods of training and rehabilitation in prepartum and postpartum periods and their effectiveness. The search for publications in English was made in two databases during the period from August 2020 to October 2020 in Cochrane Library and PubMed. 77 articles were left in total after selection—9 systematic reviews and 68 clinical trials. Existing full-text papers were reviewed after this selection. Unfinished randomized clinical trials, those which were designed as strategies for national health systems, and those which were not pelvic-floor muscle-training-specified were excluded after this step. Most trials were high to moderate overall risk of bias. Many of reviews had low quality of evidence. Despite clinical heterogeneity among the clinical trials, pelvic-floor muscle training shows promising results. Most of the studies demonstrate the positive effect of pelvic-floor muscle training in prepartum and postpartum periods on pelvic-floor dysfunction prevention, in particular in urinary incontinence symptoms. However more high-quality, standardized, long-follow-up-period studies are needed.

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