Six-Week Pelvic Floor Muscle Activity (sEMG) Training in Pregnant Women as Prevention of Stress Urinary Incontinence

Abstract

BackgroundPelvic floor muscle exercises are a widely used and well-established form of stress incontinence treatment, with success rates varying from 21% to 84%, although with a better subjective than objective outcome.Material/Methods“Incontinence Impact Questionnaire” (IIQ), PFM EMG assessment was done at the beginning and after the 6-week training program.ResultsStatistically significant differences appeared in the BASE and R values. In the symptomatic group (with SUI symptoms), the value of BASE was 3.26 μV, and after training it was 3.95 μV. The R values before and after training were 4.55 μV and 4.25 μV. In the symptomatic group (without SUI symptoms), the value of BASE was 2.88 μV and 3.52 μV and R values were 7.16 μV and 3.92 μV. In the control group, BASE was 3.05 μV and 4.11 μV and R was 7.82 μV and 4.39 μV.ConclusionsThe results indicate that a 6-week training process influences PFM EMG activity in pregnant women. During Q, the value of PFM activity after a training session tended to increase in the symptomatic and control groups, but in the symptomatic group it remains practically unchanged. Our results show the probable process of decreasing control of PFM activity during long-lasting contractions in symptomatic and control women. The comparison of BASE before and after training averaged the values of R after five 10-s contractions and showed an increase in the Base and decrease in the R.

The pathophysiology of stress urinary incontinence: a systematic review and meta-analysis

“…In some studies women with SUI were reported to have lower EMG activity of the LAMs during contractions [ 25 , 34 , 108 ] and MVCs [ 29 ] versus continent women, although the last study did not make between-group comparisons [ 29 ]. Conversely, in other studies there was higher LAM EMG activity in women with SUI during contraction [ 32 ], a static hold (although statistical comparisons were not performed) [ 31 ] and both prior to and during the postural response associated with unexpected loading [ 28 ]. The severity of incontinence experienced by women created a differential effect on LAM EMG activity—women with mild SUI demonstrated higher EMG activation amplitudes than controls ( p < 0.05 and p = 0.07 for baseline and response, respectively), while women with more severe SUI demonstrated no significant difference in EMG amplitudes than controls [ 28 ].…”

“…However, EMG amplitude was not normalized in any of these studies, putting them at high risk of detection bias [ 141 , 142 ]. Baseline/resting EMG amplitude of the LAM was similar or lower in women with SUI versus continent women in three studies where statistical comparisons between the groups were not performed because of the nature of the studies (i.e, two training studies that did not compare between groups at baseline [ 30 , 31 ] and a reliability study that recruited separate groups of women with and without SUI [ 29 ].…”

“…Parity not reported. Not clear how different types of incontinence were considered Dornowski et al (2018) [ 31 ] Poland SUI: N = 37 and mean age = 30.2. Controls: N = 76 (2 groups); mean age = 30.2 years.…”

“…• Variety of devices used: Periform™ (NEEN Mobilis Healthcare Group, UK) [ 27 – 29 ]; Lifecare PR-02 (Everyway Medical Instruments Co., Taiwan) [ 30 , 31 ]; VET-A (Nanjing Vishee Medical Technology, Ltd.) [ 32 ]; Femiscan™ (Mega Electronics Ltd., Kuopio, Finland) [ 33 , 34 ]; STIMPON™ (Innocept Biobedded System GmbH) [ 35 – 39 ], a custom probe [ 25 ] and unspecified [ 40 ] as well as disposable surface electrodes (Mediwatch, UK or Medtronic, Minneapolis, MN) attached to a sponge [ 41 , 42 ]…”

The Prognostic Value of the Surface Electromyographic Assessment of Pelvic Floor Muscles in Women with Stress Urinary Incontinence

“…Previous literature highlights the validity of using surface electromyography (sEMG) measurements when assessing pelvic floor muscle (PFM) bioelectrical activity with regard to therapeutic progress [ 1 , 2 , 3 , 4 , 5 , 6 ]. This assessment method is considered as an objective, noninvasive, and safe tool.…”