• Journal of Korean Academy of Nursing
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• v.36 no.8
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• pp.1374-1380
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• 2006

Purpose. This study was conducted to investigate the effectiveness of pelvic floor muscle exercise using biofeedback and electrical stimulation after normal delivery. Methods. The subjects of this study were 49 (experimental group: 25, control group: 24) postpartum women who passed 6 weeks after normal delivery without complication of pregnancy, delivery and postpartum. The experimental group was applied to the pelvic muscle enforcement program by biofeedback and electrical stimulation for 30 minutes per session, twice a week for 6 weeks, after then self-exercise of pelvic floor muscle was done 50-60 repetition per session, 3 times a day for 6 weeks. Maximum pressure of pelvic floor muscle contraction (MPPFMC), average pressure of pelvic floor muscle contraction (APPFMC), duration time of pelvic floor muscle contraction (DTPFMC) and the subjective lower urinary symptoms were measured by digital perineometer and Bristol Female Urinary Symptom Questionnaire and compared between two groups prior to trial, at the end of treatment and 6 weeks after treatment. Results. The results of this study indicated that MPPFMC, APPFMC, DTPFMC were significantly increased and subjective lower urinary symptoms were significantly decreased after treatment in the experimental group than in the control group. Conclusions. This study suggested that the pelvic floor muscle exercise using biofeedback and electrical stimulation might be a safer and more effective program for reinforcing pelvic floor muscle after normal delivery.

• The Transactions of the Korean Institute of Electrical Engineers P
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• v.64 no.3
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• pp.175-181
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• 2015

In this paper, the neuromuscular electrical stimulation medical devices for non-implantable incontinence treatment other than vaginal insertion type was developed and commercialized. The structure of medical devices for electrical stimulation based on the anatomy of the pelvic floor muscle designed. Then, the optimum parameters that may be effective in pelvic floor muscle electrical stimulation was set. The circuit system based on the optimum parameters were designed and manufactured. The frequency of the pulse voltage for electrical stimulation is 75[Hz], the pulse width is 300[${\mu}s$], the development of medical devices was to have seven program functions to the various treatments. The circuit system of medical devices was composed of microcontroller, comparator and converter. The performance of the developed circuit system in KTC(Korea Testing Certification) were carried out medical equipment inspection test. Test results, test specifications were satisfied with the medical device, the performance was verified to be commercialized as a medical device. The development of medical devices were validated risk assessment and product performance through a software validation. Commercialization of medical equipment was acquired to enable the certification standards of the international standard IEC 60601-1.

• Women's Health Nursing
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• v.8 no.3
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• pp.412-423
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• 2002

This study was designed to evaluate the effect of pelvic floor muscle exercise using biofeedback and electrical stimulation after normal vaginal delivery. The data were collected from November 1999 to April 2000 at a university hospital located in Seoul, Korea. Out of 49 women with normal vaginal delivery, 25 of experimental group(with exercise) and 24 of control group(without exercise) were questioned about lower urinary symptoms, discomfort during sexual intercourse and daily life. The maximum pressure of pelvic floor muscle contraction(MPPFMC) and duration of pelvic floor muscle contraction(DPFMC) were measured at pre-treatment, the end of treatment and 8 weeks after a treatment program. The pelvic floor muscle exercise program(using biofeedback and electrical stimulation) was applied to the experimental group twice a week for 4 weeks at the incontinence clinic and the pelvic floor muscle exercise at home for that time and more 8 weeks. Data were analyzed by t-test, $x^2$-test, Fisher's exact test and the repeated measures ANOVA. The results were as follows; 1) MPPFMC(p=0.000) and DPFMC(p=0.021) were significantly increased in the experimental group. 2) In the lower urinary symptoms, daily frequency(p=0.001), nocturia(p=0.002), incontinence episode(p=0.016), stress incontinence(p=0.012), quantity of incontinence(p=0.026), straining(p=0.041), and strength of stream(p=0.009) were significantly decreased in the experimental group. 3) Discomfort during sexual intercourse had not a significant difference between the two groups, which was not significantly decreased as time passed. 4) In the discomfort during daily life, activity restriction(p=0.042), exercise restriction (p=0.008), interpersonal relationship restriction(p=0.046), and discomfort of general life(p=0.027) showed a significant difference between the two groups, which were not significantly decreased as time passed. In conclusion, it is suggested that the pelvic floor muscle exercise using biofeedback and electrical stimulation might be a safer and more effective program for the improvement of postpartum pelvic muscle contraction.

• Journal of Yeungnam Medical Science
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• v.20 no.1
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• pp.36-44
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• 2003

Background: To evaluate the efficacy of EMG biofeedback and pelvic floor electrical stimulation in the stress urinary incontinence patients by Kontinence HMT2000. Materials and Methods: A group of 14 patients with stress urinary incontinence were treated with combined biofeedback and intravaginal electrical stimulation during 12 sessions from 2 weeks to 6 weeks. Results: At immediate post treatment, subjective cure rate was 28% and improvement rate was 57% and failure rate was 15%. Thus the overall success rate for this treatment was 85%. The result of 3 months after treatment showed cure rate 14% and improvement rate was 43%. Intravaginal pressure increased by an average of 11.9 cmH2O. Increased vaginal pressure was found in 93% of the patients and more than 50% increment of intravaginal pressure was 71%. Conclusions: Combined biofeedback and pelvic floor electrical stimulation by use of Kontinence HMT2000 is effective for the patients who have good compliance, relative low degree stress urinary incontinence. In order to attain good results, a well structured program that teaches specific muscle exercise and the patients should be followed by regular interval reinforcement treatment.

• Physical Therapy Korea
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• v.26 no.3
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• pp.67-75
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• 2019

Background: Stress urinary incontinence (SUI) is an involuntary leakage of urine from the urethra when intra-abdominal pressure increases, such as from sneezing, coughing, or physical exertion. It is caused by insufficient strength of the pelvic floor and sphincter muscles, resulting from vaginal delivery, obesity, hard physical work, or aging. The pelvic floor electrical stimulator is a conservative treatment generally used to relieve the symptoms of urinary incontinence. it recommended to applied before surgery is performed. Objects: The purpose of this study was to determine if the transcutaneous electrical stimulation (TCES) would be effective for the physiological symptoms and psychological satisfaction of women with SUI for an 8-weeks intervention. Methods: Easy-K is a specially designed user-friendly TCES. Five female who were diagnosed with SUI by a gynecologist but who did not require surgical intervention were included in this study. Intervention was implemented over an 8-week period. Outcome measures included vaginal ultrasonography, Levator ani muscle (LAM) contraction strength, incontinence quality of life (I-QOL), and female sexual function index (FSFI) questionnaires. Results: The bladder neck position significantly decreased across assessment time. Funneling index and urethral width significantly decreased after 8 weeks of intervention (p<.05). The bladder necksymphyseal distance and posterior rhabdosphincter thickness statistically increased and the anterior rhabdosphincter thickness showed a tendency to increase. All participants demonstrated a significant increase in the LAM contraction score across three assessment times (p<.05). Although the total score of the I-QOL did not show significant improvement, it steadily increased and among I-QOL subscales, only the "avoidance" subscale showed statistical improvements (p<.05). The total score of the FSFI statistically improved and the "desire" score significantly changed (p<.05). Conclusion: The TCES is recommended for women who want to apply conservative treatments before surgery and who have suffered from SUI in aspects of sexual function and quality of life.

• The Journal of Korean Physical Therapy
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• v.12 no.2
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• pp.267-273
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• 2000

The 30 percent or more women who have urinary incontinence have some problem in contraction of perineal muscles. In fact. to increase the strength of perineal muscles, voluntary muscle contraction is more effective than electrical contraction. Electrical stimulation or bio feedback therapy is safe and effective therapy for Patients who have complex urinary incontinence. because these therapies can solve the problems of the voluntary perineal muscle contraction these therapies can help women to know to contract the perineal muscles effectively. The combined therapy ie. Electrical stimulation and bio feedback therapy with pelvic muscle training program or bladder drill can be considered as good treatment method. Pelvic floor muscle exercise is importance to make patient itself participate by making to be interested about exercise and by tacking motivations at therapy to themselves.

• International Neurourology Journal
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• v.22 no.4
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• pp.295-304
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• 2018

Purpose: To compare the effects of intra-anal biofeedback (BF) and intra-anal electrical stimulation (ES) on pelvic floor muscles (PFMs) activity, nocturnal bladder capacity, and frequency of wet night episodes in children with refractory primary monosymptomatic nocturnal enuresis (PMNE). Methods: Ninety children of both sexes aged 8-12 years with refractory PMNE participated in this study. They were randomly assigned to 3 groups of equal number: control group (CON) that underwent behavioral therapy and PFM training, and 2 study groups (BF and ES) that underwent the same program in addition to intra-anal BF training and intra-anal ES, respectively. PFMs activity was assessed using electromyography, nocturnal bladder capacity was evaluated by measuring the first morning voided volume, and a nocturnal enuresis diary was used for documenting wet night episodes before treatment and after 3 months of treatment. Results: After training, all groups showed statistically significant improvements in all measured outcomes compared to their pretreatment findings. The ES group showed significantly greater improvements in all measured outcomes than the CON and BF groups. Conclusions: Both intra-anal BF training and ES combined with behavioral therapy and PFMs training were effective in the treatment of PMNE, with intra-anal ES being superior to BF training.

• Journal of Yeungnam Medical Science
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• v.21 no.2
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• pp.207-214
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• 2004

Purpose: This study was carried out to evaluate the efficacy of intravaginal pelvic floor electrical stimulation (FES) therapy on bladder irritability symptoms in stress urinary incontinent women. Materials and Methods: The evaluation before and after treatment included the Blaivas's female Bladder Questionnaire, the quality of life questionnaires and the overall satisfaction with present voiding state using visual analogue test (VAT). All patient were treated for 20 minutes, twice a week for 6 weeks, using a new intravaginal electrical stimulator with microchip (PIC16C74). Results: After the FES therapy, the overall success rate of the SUI was 50.4.% at 9 months. The bladder irritability symptoms such as frequency, nocturia, urgency, residual urine sensation and lower abdominal discomfort were improved. In particular, the symptoms of frequency, urge incontinence, dysuria were significantly improved after the FES therapy at 9 months. The VAT score of the overall satisfaction with the present voiding state was significantly lower after the FES therapy. 73.7% of patients were satisfied with the FES therapy and complications such as hemorrhage, vaginitis, urinary tract infection and pain were not encountered. Conclusion: These results suggest that FES therapy with microchip improves some bladder irritability in SUI women. Therefore, electrical stimulation therapy should be considered as a first line therapy in SUI women with bladder irritability symptoms.

• Physical Therapy Korea
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• v.31 no.2
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• pp.167-173
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• 2024

Background: Stress urinary incontinence (SUI) impacts the social, physical, and psychological well-being and quality of life of the patient. Several techniques exist for its management, including transcutaneous electrical stimulation (TES). Objects: We aimed to demonstrate the effects of TES on ultrasonographic variables and quality of life in women with SUI. Methods: This prospective study recruited 21 women who had been diagnosed with grade 1 or 2 SUI between July 2018 and March 2019. The exclusion criteria were pregnancy and a history of urogenital surgery. All participants were assessed at baseline and 8 weeks after intervention initiation. The bladder neck position (BNP), length of the urethra (LU), funneling index (FI), and rhabdosphincter thickness (RT) were measured. The Incontinence-Quality of Life (I-QOL) was used to assess incontinence-specific quality of life. Statistical significance level was set at p < 0.05. Results: Twenty-one patients with SUI used TES for 8 weeks. BNP and FI significantly decreased after intervention (p < 0.05). LU, anterior and posterior RT (indicators of external sphincter hypertrophy) significantly increased post-intervention (p < 0.05). The total I-QOL score increased from 64.81 to 71.86 after the intervention (p < 0.05). Conclusion: This intervention improved BNP, LU, FI, RT, and subjective indicators such as quality of life in women with SUI. Therefore, TES can be an effective non-surgical treatment method for improving SUI symptoms and quality of life in these patients.