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Continence
Published in Andrew Stevens, James Raftery, Jonathan Mant, Sue Simpson, Health Care Needs Assessment, 2018
Catherine W. McGrother, Madeleine Donaldson
Not all women are able to perform pelvic floor exercises correctly and so may require instruction and supervision from a nurse or physiotherapist. Adjuncts such as biofeedback and electrical stimulation are also commonly used with PFMT. Biofeedback is most commonly employed when using a perineometer to measure pelvic floor muscle strength. The use of electrical stimulation in the treatment of incontinence is described in detail by Laycock.107 Use of this mode of treatment has increased in recent years, partly due to the introduction of portable equipment. The technique has been used in both neurologically and non-neurologically impaired individuals to manage both bladder and urethral dysfunction. Electrical stimulation is usually given to mimic a normal pelvic floor muscle contraction and is a treatment option for patients who are unable to produce a voluntary contraction or only a weak contraction. Such electrical stimulation recruits muscle fibres. Having been made aware of the specific pelvic floor muscle activity by means of electrical stimulation, the patient then tries to join in and reproduce the contraction. Naturally, these adjunctive treatments do require nursing or physiotherapy input.
Urogenital prolapse
Published in David M. Luesley, Mark D. Kilby, Obstetrics & Gynaecology, 2016
Sushma Srikrishna, Dudley Robinson
Pelvic floor exercises may have a role in the treatment of women with symptomatic prolapse, although there are no objective evidence-based studies to support this. Education about pelvic floor exercises may be supplemented with the use of a perineometer and biofeedback, allowing quantification of pelvic floor contractions. In addition, vaginal cones and electrical stimulation may also be used, although again, while they have been shown to be effective in the treatment of urodynamic stress incontinence, there are no data to support their use in the management of urogenital prolapse.
Biofeedback Treatment for Functional Anorectal Disorders
Published in Laurence R. Sands, Dana R. Sands, Ambulatory Colorectal Surgery, 2008
In the late 1940s Arnold Kegel developed a vaginal balloon perineometer to teach pelvic muscle exercises for poor tone and function of the genital muscles. He was instrumental in developing a standardized program for treating urinary stress incontinence. Kegel’s program included evaluation and training utilizing visual feedback for patients to receive positive reinforcement as they monitored improvements in the pressure readings. Kegel also recommended structured home practice with the perineometer along with symptom diaries. His clinical use of these techniques showed that muscle reeducation and resistive exercises guided by sight sense to be a simple and practical means of restoring tone and function of the pelvic musculature. This perineometer was developed before the term “biofeedback” was coined in the late 1960s (84).
Association between preterm labour and pelvic floor muscle function
Published in Journal of Obstetrics and Gynaecology, 2018
Turhan Aran, Ipek Pekgöz, Hasan Bozkaya, Mehmet A. Osmanagaoglu
The vaginal resting pressure (VRP) and the PFM strength were measured to evaluate the pelvic floor muscle function. They were measured at the first trimester during the aneuploidy screen. The measurements were conducted by one of our study team (P.I.) who was blinded to the obstetric outcome and did not perform the data analysis. The Peritron perineometer (Cardio Design Pty Ltd., Oakleigh, Australia, Figure 1) was used to evaluate the PFM function (Ferreira et al. 2011). The perineometer measures vaginal pressure through a conical sensor which is connected to a hand-held microprocessor with a latex tube. Pregnant women were taught how to perform a correct PFM contraction by using their observation and palpation before the measurement. A PFM contraction without any movement of the pelvis or visible contraction of the glutaei, the hip or the abdominal muscles was emphasised. The vaginal sensor was placed into the vaginal canal after the calibration was set to zero. The vaginal resting pressure (VRP) was measured and then a pregnant woman was asked to contract her pelvic floor muscles. Only contractions with the visible inward movement of the perineum with no visible co-contraction of the hip adductor, glutaeal or rectus abdominis muscles were considered to be valid (Bo et al. 1990). Three squeezes were recorded with a 5–second rest interval and the maximum squeeze pressure was accepted as the PFM strength. All of the assessments were done in the dorsal lithotomic position.
Authors’ reply
Published in Climacteric, 2018
D. A. S. Bocardi, V. S. Pereira-Baldon, C. H. J. Ferreira, M. A. Avila, A. C. S. Beleza, P. Driusso
The Peritron perineometer is the device which has been most tested for its measuring properties. High agreement was found between PFM evaluations performed on the same day using the Peritron, indicating that this may be considered a reproducible method of PFM maximal voluntary contraction and endurance in healthy women, when executed by the same evaluator4. The Peritron has also demonstrated very good intra-rater reproducibility for PFM maximal voluntary contraction in four different positions: supine with hip and knee flexion, supine, sitting, and standing5. Inter-rater reproducibility of PFM contraction with the Peritron was considered acceptable6. Excellent inter-rater reproducibility was obtained for average and maximal values of three PFM maximal voluntary contractions obtained with the Peritron for women in the first trimester of gestation and good to moderate inter-rater reproducibility for women in the second trimester of gestation7.
A comparison of Kinesio taping and external electrical stimulation in addition to pelvic floor muscle exercise and sole pelvic floor muscle exercise in women with overactive bladder: a randomized controlled study
Published in Disability and Rehabilitation, 2022
Seyda Toprak Celenay, Yasemin Karaaslan, Ozge Coban, Kemal Oskay
The strength of pelvic floor muscle was assessed with a PFX perineometer (Cardio Design Pty Ltd, Castle Hill, Australia). The women were asked to lie in a lithotomy position. The probe of the perineometer was placed in their vagina. For correct contraction, the women were asked to breath normally and without co-contraction of the hip or abdominal muscles, and then to contract their pelvic floor muscles as hard as possible as if preventing the escape of urine or flatus. Perineometer outcomes ranged between 0 and 12 kilo Pascal (kPa). The difference between the first and the last value indicated on the perineometer was recorded. The average of the three assessments were recorded as the PFMS.