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How Do Pelvic Floor Muscle Contractions Elicited by 2 Different Delivery Methods of Neuromuscular Electrical Stimulation Compare With Volitional Contractions in Supine and Standing in Nulliparous Continent Women?

Objective: This study compared volitional pelvic floor muscle (PFM) contractions with those elicited by 2 delivery methods of neuromuscular electrical stimulation (NMES) in 2 positions using transabdominal ultrasound (TAUS) imaging to assess bladder base elevation (BBE). Study Design: A repeated-measures design. Background: Pelvic floor exercises and NMES are prescribed to improve PFM contraction. However, the evidence regarding efficacy of transvaginal NMES (TvNMES) in eliciting a contraction has been limited by inadequate description of how PFM contraction was determined. Methods and Measurement: Six healthy females were recruited for this preliminary study. Volitional PFM and NMES-elicited contractions were assessed in the supine and standing positions; order was randomly assigned with at least a 24-hour washout period. An NMES unit with a vaginal electrode (TvNMES) and a device using externally applied electrodes embedded in a garment (EES) were used. PFM activity was assessed via BBE using TAUS imaging. Two-way repeated analysis of variance was used, with statistical significance being P < .05. Results: Greater BBE was seen for EES versus TvNMES (P = .004) in both positions. Volitional PFM contractions elicited greater BBE than TvNMES in both positions (P = .003) and were not significantly different when compared with EES (P = 0.98). Comparison between interventions in 2 positions resulted in statistically significant difference favoring the standing position (P = .002). Conclusion: The EES device in this study was shown to facilitate significantly greater BBE than a TvNMES device and was well tolerated by the healthy participants. More importantly, EES elicited a contraction similar to volitional PFM contractions.