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      Electromyographic Evaluation of the Pelvic Muscles Activity After High-Intensity Focused Electromagnetic Procedure and Electrical Stimulation in Women With Pelvic Floor Dysfunction

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Introduction

          Impaired coordination, relaxation, and atrophy of pelvic floor muscles (PFMs) may cause various health issues referred to as pelvic floor dysfunction (PFD). In recent years, electromagnetic noninvasive stimulation of the pelvic floor was successfully used to treat PFD symptoms.

          Aim

          This study aims to compare the effectiveness of electrical and magnetic noninvasive stimulation for the treatment of PFD in postpartum women.

          Methods

          2 intervention groups treated with high-intensity focused electromagnetic ([HIFEM]; G1) procedure and electrical stimulation (G2) were established along with the control group (G3). Patients received 10 therapies delivered at the hospital (G1; 2–3 times per week) or self-administered at home (G2; every other day) after initial training. The protocol was identical for both modalities. Functionality of the PFM was examined by surface electromyography measurements (maximal voluntary contraction [MVC]; mean MVC; muscle activity at rest; endurance of contraction) while patient's subjective perception of pelvic floor functionality was assessed by Pelvic Floor Impact Questionnaire–Short Form 7 (PFIQ-7) standardized questionnaire. Changes in electromyography values and PFIQ-7 scores were statistically evaluated from baseline to after all treatments.

          Main Outcome Measure

          The main outcome measure was enhancement of PFM activity.

          Results

          In total, 95 patients (G1 = 50; G2 = 25; G3 = 20) participated in the study. The MVC, mean MVC, and endurance were lowered in symptomatic patients. After the treatments, these parameters significantly increased ( P < .001) and moved toward the values of healthy population. Electrogenesis at relaxation revealed divergent tendencies in the G1 and G2 groups. PFIQ-7 scores significantly improved in treated patients ( P < .001). In general, superior results were documented in the HIFEM group as it reached improvement of electromyography parameters from 48% to 59% (electrical stimulation from 7% to 36%) and similarly the improvement of PFIQ-7 score by 57% (electrical stimulation by 32%).

          Conclusion

          This study documented that the HIFEM procedure was significantly more effective than electrical stimulation in treatment of PFD in postpartum women. Both the objective and subjective evaluation indicates more profound effects of magnetic stimulation.

          Elena S, Dragana Z, Ramina S, et al. Electromyographic Evaluation of the Pelvic Muscles Activity After High-Intensity Focused Electromagnetic Procedure and Electrical Stimulation in Women With Pelvic Floor Dysfunction. Sex Med 2020;8:282–289.

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          Most cited references 32

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          The Use of Surface Electromyography in Biomechanics

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            Techniques of EMG signal analysis: detection, processing, classification and applications

            Electromyography (EMG) signals can be used for clinical/biomedical applications, Evolvable Hardware Chip (EHW) development, and modern human computer interaction. EMG signals acquired from muscles require advanced methods for detection, decomposition, processing, and classification. The purpose of this paper is to illustrate the various methodologies and algorithms for EMG signal analysis to provide efficient and effective ways of understanding the signal and its nature. We further point up some of the hardware implementations using EMG focusing on applications related to prosthetic hand control, grasp recognition, and human computer interaction. A comparison study is also given to show performance of various EMG signal analysis methods. This paper provides researchers a good understanding of EMG signal and its analysis procedures. This knowledge will help them develop more powerful, flexible, and efficient applications.
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              Psychometric evaluation of 2 comprehensive condition-specific quality of life instruments for women with pelvic floor disorders.

              To evaluate the psychometric properties of the Pelvic Floor Distress Inventory (PFDI) and the Pelvic Floor Impact Questionnaire (PFIQ). The PFDI and PFIQ are based on the structure and content of two previously validated questionnaires (the Urinary Distress Inventory [UDI] and the Incontinence Impact Questionnaire [IIQ]) and have additional questions regarding pelvic organ prolapse and colorectal dysfunction. The PFDI assesses symptom distress in women with pelvic floor disorders and has 3 scales: UDI (28 items), Colorectal-anal Distress Inventory (17 items), and Pelvic Organ Prolapse Distress Inventory (16 items). The PFIQ assesses life impact and also has 3 scales: IIQ, Colorectal-anal Impact Questionnaire, and the Pelvic Organ Prolapse Impact Questionnaire (31 items each). One hundred women with pelvic floor symptoms were enrolled and completed both the PFDI and PFIQ at baseline and again 1 week later. Patients underwent a comprehensive evaluation that included a structured history, Pelvic Organ Prolapse Quantitation, and a 1-week prospective bowel/bladder diary. Patients with urinary incontinence and stage III or IV pelvic organ prolapse also had a urodynamic evaluation. Each scale of the PFDI and PFIQ proved to be internally consistent (alphas: PFDI.82-.89; PFIQ.96-.97) and reproducible (interclass correlations: PFDI.86-.87; PFIQ.77-.92). Both the UDI and the IIQ significantly correlated with the number of urinary incontinence episodes per week (rho =.26, P <.05; rho =.46, P <.0001, respectively) and the number of pads used per week (rho =.26, P <.05; rho =.40, P <.0001, respectively). The Pelvic Organ Prolapse Distress Inventory and the Pelvic Organ Prolapse Impact Questionnaire significantly correlated with the stage of prolapse (rho =.32 and rho =.33, P <.01 each), and the Colorectal-anal Distress Inventory and Colorectal-anal Impact Questionnaire significantly correlated with the number of fecal incontinence episodes per month (rho =.49, P <.0001 and rho =.30, P <.01) and a diagnosis of defecatory dysfunction (rho =.47, P <.0001 and rho =.29, P <.01). The total time taken to complete both instruments averaged 23 minutes (range, 9-55). The PFDI and the PFIQ are reliable, valid, condition-specific quality of life instruments for women with pelvic floor disorders.
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                Author and article information

                Contributors
                Journal
                Sex Med
                Sex Med
                Sexual Medicine
                Elsevier
                2050-1161
                04 March 2020
                June 2020
                04 March 2020
                : 8
                : 2
                : 282-289
                Affiliations
                [1 ]Hospital Lapino (MD Medical Group), Moscow, Russia
                [2 ]Faculty of Physical Education and Sport, Department of Anatomy and Biomechanics, Charles University, Prague, Czech Republic
                [3 ]Medical Faculty, Department of Obstetrics and Gynecology, RUDN University, Moscow, Russia
                Author notes
                [] Corresponding Author: Silantyeva Elena, MD, Hospital Lapino MD Medical Group, 111, Lapino village, Odintsovo District 143081, Moscow Region, Russia. Tel: +7-916-060-20-00; Fax: +7-495-433-73-79 essdoktor@ 123456yandex.ru
                Article
                S2050-1161(20)30007-6
                10.1016/j.esxm.2020.01.004
                7261686
                © 2020 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                Categories
                Women's Sexual Health

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