An Introduction to Urinary Incontinence.

Cover Story:
BioStim™ for Pelvic Floor Strengthening'
Dorothy Stevens RN. RM. Continence Consultant & Practitioner.

Therapy Closeup:
Pelvic Floor Strengthening

Bits n' Pieces:
Bio Notes:
Dorothy Stevens

User Profiles:
Those with incontinence tell their stories.

The Fact Files:
Scientific research in support of Electrical Stimulation for urinary incontinence.

Pelvic-floor rehabilitation, Part 2: Pelvic-floor reeducation with interferential currents and exercise in the treatment of genuine stress incontinence in postpartum women -- a cohort study.

Dumoulin C, Seaborne DE, Quirion-DeGirardi C, Sullivan SJ

Phys Ther 1995 Dec;75(12):1075-81

Hopital Ste-Justine de Montreal, Quebec, Canada.

BACKGROUND & PURPOSE: This descriptive cohort study investigated a physical therapy program of pelvic-floor neuromuscular electrostimulation (NMES) combined with exercises, with the aim of developing a simple, inexpensive, and conservative treatment for postpartum genuine stress incontinence (GSI).

SUBJECTS: Eight female subjects with urodynamically established GSI persisting more than 3 months after delivery participated in the study. The subjects ranged in age from 24 to 37 years (X = 32, SD = 4.2).

METHODS: This was a descriptive multiple-subject cohort study. Each subject received a total of nine treatment sessions during 3 consecutive weeks, consisting of two 15-minute sessions of NMES followed by a 15-minute pelvic-floor muscle exercise program.

Patients also practiced daily pelvic-floor exercises during the 3-week treatment period. The treatment intervention was measured using three separate variables. Maximum muscle contractions (pretraining, during training, and post-training) were measured indirectly as pressure, using perineometry. Urine loss pretraining and posttraining was measured by means of a Pad test.

Self-reported frequency of incontinence was recorded daily throughout the period of the study, using a diary. Data were analyzed using a one-way repeated-measures analysis of variance (ANOVA), a Wilcoxon signed-ranks test, and a Friedman two-way ANOVA by ranks.

RESULTS: The results indicated that maximum pressure generated by pelvic-floor contractions was greater and both the quantity of urine loss and the frequency of incontinence were lower following the implementation of the physical therapy program. Five subjects became continent, and three others improved. A follow-up survey 1 year later confirmed the consistency of these results.

CONCLUSION AND DISCUSSION: The results suggest that the proposed physical therapy program may influence postpartum GSI. Further studies are needed to validate this simple, inexpensive, and conservative physical therapy protocol.

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