EMG biofeedback as a diagnostic and therapeutic method in the treatment and prevention of women’s urinary incontinence
Keywords:
biofeedback method, stress urinary incontinence, pelvic floor, abdominal musclesAbstract
In our research we have tried to objectivise pelvic floor muscle contractions in its maximal and average values and patient’s ability of muscle relaxation with the aid of EMG biofeedback and also the Perfect Scheme objectivisation with the above in the form of a resultant electromyogram. We have also objectivised the relaxation of m.rectus abdominis during training exercises. We have compared the monitored parameters in women with and without urinary incontinence and have tried to reduce the urinary incontinence symptoms by a complex physiotherapeutic treatment.
Patient group: The group consisted of 66 patients out of which number there were 46 incontinent women and 20 women without urinary incontinence (UI). Patients were after vaginal and abdominal hysterectomy.
Methods used: Surface electromyography (EMG) for the evaluation of pelvic-floor functionality according to Perfect Scheme (performance, endurance and repetitions of contractions, fast contractions, every contraction timed). For the quantification of urine leakage one hour pad weight test has been used. Contlife questionnaire covered the quality of life of stress urinary incontinence patients.
Rehabilitation methods: Exercises for stretching, strengthening and relaxing pelvic floor (PF) muscles by means of repeated selected willful contraction or relaxation of PF muscles carried out two times a day with duration time 15 minutes. Group exercises for stretching and relaxing PF muscles two times a week, duration time 30 minutes. Results: After the complex rehabilitation treatment a statistically significant retreat of urinary incontinence has been achieved. Statistically significant relation (r = -0,32) between the strength of PF muscles in (µV) and urinary incontinence in grams (g) has been confirmed the weaker the PF muscles, the more expressive urinary incontinence symptoms and vica versa. Objectively assessed by biofeedback, statistically significant pelvic floor muscles strength increase and improvement of monitored parameters according to Perfect Scheme after the treatment have been proven. We have found that women without urinary incontinence were able to contract pelvic floor muscles without observed muscles fatigue. In the ability to relax abdominal muscles during exercises there were no significant diffe rences recorded between these two groups
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