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

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; 2e3 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 QuestionnaireeShort 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 ¼ 50; G2 ¼ 25; G3 ¼ 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;8:282e289.

Effectiveness of Magnetic Stimulation in the Treatment of Urinary Incontinence: A Systematic Review and Results of Our Study

“…Forty-five articles were excluded for any of the following reasons: they were not in English, they were review articles or meta-analyses, only males were subjects of the research, they were case reports or they were conference abstracts, or there were no possibilities for analyzing the success rate of the treatment. Thus 12 articles [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ], summarized in Table 1 , Table 2 , Table 3 , Table 4 and Table 5 , represented the object of this review.…”

“…Five studies were randomized, double blinded, and sham controlled [ 20 , 21 , 22 , 23 , 24 , 32 ], and the rest were prospective studies without a control group [ 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Most studies used MS only for treating patients with SUI [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 31 , 32 ], whereas Samuels et al [ 27 ], Vadala et al [ 28 ], and Sun et al [ 30 ] treated patients with all three types of UI: SUI, UUI, and MUI. On the other hand, Doğanay et al [ 29 ] included patients with SUI and UUI.…”

“…However, the greatest improvement was observed in the EMG-biofeedback training group for QoL scores in comparison to MS and pelvic floor muscle training. In the most recent study on this topic, Silantyeva et al [ 26 ] examined the effectiveness of MS versus pelvic floor muscle electrostimulation. In addition to the subjective evaluation with the Pelvic Floor Impact Questionnaire Short Form 7 (PFIQ-7), the researchers also used 3D ultrasound to objectively evaluate and later compare PFM anatomy and integrity.…”

“…They concluded that MS is a highly user-friendly modality for the conservative treatment of female UI. In the most recent study on this topic, Silantyeva et al [ 26 ] examined the effectiveness of MS versus electrostimulation after short-term therapy (10 sessions) in postpartum women of childbearing age who had had a vaginal delivery in the previous 6 months. In addition to the subjective evaluation, a 3D ultrasound was used to objectively evaluate and later compare the PFM anatomy and integrity.…”

Efeitos e Aplicações do Campo Eletromagnético de Alta Intensidade (PEMF) em saúde e estética: perspectivas e evidências clínicas

“…Recentemente, Elena et al (2020) demonstraram, em um estudo controlado com 95 pacientes, o aumento significativo de tônus muscular na musculatura pélvica, e que esse aumento foi mais efetivo do que aquele observado com estimulação elétrica. Neste estudo, a tonificação muscular foi avaliada através de análise eletromiográfica da musculatura do assoalho pélvico, considerado o mais apropriado para tal objetivo.…”