Krystyna Garstka-Namysł, Grzegorz Henryk Bręborowicz, Łucja Pilaczyńska-Szcześniak, Juliusz Huber, Stefan Sajdak, Magdalena Pisarska, Kamila Witczak, Łukasz Sroka, Alicja Witkowska

Krystyna Garstka-Namysł, Grzegorz Henryk Bręborowicz, Łucja Pilaczyńska-Szcześniak, Juliusz Huber, Stefan Sajdak, Magdalena Pisarska, Kamila Witczak, Łukasz Sroka, Alicja Witkowska – Functional stimulation of perineal muscles in women with urinary incontinence after gynecological surgery and its effect on quality of life changes. Fizjoterapia Polska 2007; 7(2), 124-132

Abstract

Background. Urinary incontinence and disturbances of perineal muscle and nerve activity in women after gynecological surgery have a major influence on the patients’ quality of life. Using global EMG data, it is possible to customize parameters for spinal FES and perineal EMS treatments and to objectively assess treatment outcomes. Material and methods. 15 women after gynecological surgery with disturbances of micturition underwent gynecological and urodynamic assessments, sonography, global EMG with a vaginal probe and magnetic field-induced motor evoked potentials (MEP) tests. The parameters for EMS and FES were customised on the basis of those diagnostic tests and the treatments were self-administered by patients for 2 months. Quality of life changes were assessed with Prof. Kowalik’s quality of life assessment scale at baseline and at the end of the treatment. Results. In 12 patients, EMG and MEP recordings revealed that the disturbances were caused by axonal degeneration of motor fibres rather than by impaired impulsation at the spinal centre level. Mean values of perineal muscle resting potentials were 2.52 pV before and 1.87 pV after treatment. Contraction strength rose from 14.7 pV to 16.9 pV The self-reported 20-domain quality of life scale showed increased current and future-oriented satisfaction with life. Conclusions. A two-month cycle of FES and EMS improved motor unit function at maximum contraction. MEP studies revealed improved conduction from spinal motor centres to muscles, especially if EMS of perineal muscles had been supplemented with lumbo-sacral FES.

Key words:

urinary incontinence, spinal functional electrical stimulation (FES), surface electromyography, ETS and EMG biofeedback, perineal muscles, quality of life

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