Authors (including presenting author) :
Chan SLS, Pang SK, Leung HC, Tse TK, Ling WY, Chao YLC, Leung YYC
Affiliation :
Physiotherapy Department, Princess Margaret Hospital
Introduction :
Urinary incontinence is a prevalent medical condition among women. It was estimated that 25% women aged 30 to 59 experienced incontinence symptoms. Extracorporeal electromagnetic stimulation (ExMS) was developed for promoting pelvic floor muscle strength (PFMS) in management of urinary incontinence. This technology has been implemented in the Physiotherapy Department of Princess Margaret Hospital (PMH) for more than 10 years.
Objectives :
To evaluate the effectiveness of ExMS in combination with pelvic floor exercise (PFE) training for the management of urinary incontinence in woman.
Methodology :
Female patients diagnosed with stress or mixed (stress and urge) urinary incontinence, PFMS≤4 and referred for physiotherapy out-patient management at PMH was recruited. All patients attended an educational class on PFE training and lifestyle advice. They were encouraged to conduct PFE as home-based exercise program on daily basis. In addition, each patient received 8 sessions of ExMS using the NeoControl chair (NeoTonus, Marietta, GA, USA), 1 session per week for 8 weeks. Stimulation parameters was set at 10Hz in the initial 10 minutes and then at 50 Hz for another 10 minutes, at a power intensity of approximately 50%, in a 5-second on, 5-second off cycle. Patients were instructed to perform PFE during the stimulation.
Outcome measures included PFMS, measured with manual testing Oxford Muscle Scale, Urogenital Distress Inventory-Short Form (UDI-6), Incontinence Impact Questionnaire-Short Form (IIQ-7) and weekly incontinence episodes, which were recorded at pre- and post-treatment. Additionally, the Numeric Global Rating of Change Scale (NGRCS) was assessed post-treatment.
Result & Outcome :
Ten female patients aged 51±13.9 years received the interventions. PFMS median score improved significantly from 3 to 4 after 8 sessions (p<0.05) of ExMS in combination with daily home-based PFE training. Mean UDI-6 scores decreased significantly from 9.5±3.9 to 5.5±2.2 (p<0.05), indicating reduction in urinary distress symptoms. Moreover, frequency of weekly incontinence episodes significantly declined from 15.1±11.3 to 7.5±7.1 (p<0.05). Mean NGRCS score was 4.9±2.1, implying subjective improvement of patients in perceived symptoms.
Measures of psychosocial component by IIQ-7 reduced from 4.8±4.3 to 3.0±1.7 but did not reach statistical significance.
The preliminary findings demonstrated that the combination of ExMS together with home-based PFE training was effective in managing female patients with stress or mixed urinary incontinence in domains of improving PFMS, reducing episodes of incontinence and improving psychosocial symptoms.
