Pelvic floor muscle retraining : a quantitative, randomized, experimental, pilot study

Bernier, Francie S., School of Nursing, University of Virginia
Gray, Mikel, UPG-MD-UROL Urology Dept, University of Virginia
Parker, Barbara, School of Nursing, University of Virginia
Ratliff, Catherine, CV Surgery APPs, University of Virginia
Hullfish, Kathie, School of Medicine, University of Virginia

Aims: The aims of this study were: 1) To determine the proportion of women who can correctly perform Kegel exercises after verbal instructions. 2.) To predict which intervention; active participation in the stimulation (patient initiated contractions during the last five minutes of the ten minute session), passive electrical stimulation (no participation by the subject during the ten minute session) or 2 channels of EMG biofeedback with verbal instructions will assist women to correctly contract the pelvic floor muscle. 3.) To determine if the results of the interventions are different at two time points, immediately following the intervention and after a 5-minute rest period.
Design: Descriptive analysis revealed the proportion of women unable to contract their pelvic floor muscle following verbal instructions. An experimental, randomized, quantitative, pilot study reported the most efficacious interventions to assist in the retraining process of the pelvic floor measured at 2 time points.
Methods: Ninety-six subjects volunteered to participate in the study between March, 2007-July, 2007. Subjects received verbal instructions of Kegel exercise during a session of 2-channel surface electromyography (EMG) recording their ability to perform Kegel exercise following verbal instructions and defined by the study's operational definition. The women unable to correctly contract their pelvic floor muscle were randomized into the interventional study.
Results: Sixty-eight percent (n=66) of the women were unable to contract their pelvic floor muscle and were randomized into the interventional study. The 2 methods of transvaginal electrical stimulation delivery were found to be statistically significant in assisting women to contract their pelvic floor muscle as compared to the two channels of EMG biofeedback immediately following the intervention and following a 5-minute rest period.
Conclusions: Verbal instructions are not an adequate method of instruction for women who cannot contract their pelvic floor muscle. Both methods of transvaginal stimulation were statistically significant as compared to the EMG-biofeedback group in their ability to assist the women to contract their pelvic floor muscle at both time points, immediately after the intervention and following a 5-minute rest period. 

PHD (Doctor of Philosophy)
Pelvic Floor--physiology, Exercise Therapy--methods, Urinary Incontinence--nursing, Urinary Incontinence--therapy, Urinary Incontinence/nursing--rehabilitation, Self Care, Treatment Outcome, Rehabilitation
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