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Pelvic-Floor Rehabilitation, Part 1: Comparison of Two Surface Electrode Placements During Stimulation of the Pelvic-Floor Musculature in Women Who Are Continent Using Bipolar Interferential Currents

C Dumoulin, MSc, PT, is Physical Therapist, Hôpital Ste-Justine de Montréal, 3175 Côte Ste-Catherine, Montréal, Québec, Canada H3T 1C5, and Teaching Assistant and Lecturer, L'Ecole de Réadaptation, Faculté de Médecine, Université de Montréal, Montréal, Québec, Canada H3C 3J7.
DE Seaborne, MSc, PT, is Professor, Department of Physiotherapy, L'Ecole de Réadaptation, Faculté de Médecine, Université de Montréal.
C Quirion-DeGirardi, MA, PT, is Associate Professor (ret), L'Ecole de Réadaptation, Faculté de Médecine, Université de Montréal.
SJ Sullivan, PhD, is Associate Professor and Chair, Department of Exercise Science, Concordia University, Montréal, Québec, Canada H4B 1R6, and is affiliated with the Centre de Recherche, Institut de Réadaptation de Montréal, 6300 Darlington Ave, Montréal, Québec, Canada H3S 2J4, and L'Ecole de Réadaptation, Faculté de Médecine, Université de Montréal.

Background and Purpose. Electrical stimulation of the pelvic floor is used as an adjunct in the conservative treatment of urinary incontinence. No consensus exists, however, regarding electrode placements for optimal stimulation of the pelvic-floor musculature. The purpose of this study was to compare two different bipolar electrode placements, one suggested by Laycock and Green (L2) the other by Dumoulin (D2), during electrical stimulation with interferential currents of the pelvic-floor musculature in continent women, using a two-group crossover design. Subjects. Ten continent female volunteers, ranging in age from 20 to 39 years (=27.3, SD=5.6), were randomly assigned to one of two study groups. Methods. Each study group received neuromuscular electrical stimulation (NMES) of the pelvic-floor musculature using both electrode placements, the order of application being reversed for each group. Force of contraction was measured as pressure (in centimeters of water [cm H₂O]) exerted on a vaginal pressure probe attached to a manometer. Data were analyzed using a two-way, mixed-model analysis of variance. Results. No difference in pressure was observed between the two electrode placements. Differences in current amplitude were observed, with the D2 electrode placement requiring less current amplitude to produce a maximum recorded pressure on the manometer. Subjective assessment by the subjects revealed a preference for the D2 electrode placement (7 of 10 subjects). Conclusion and Discussion. The lower current amplitudes required with the D2 placement to obtain recordings comparable to those obtained with the L2 technique suggest a more comfortable stimulation of the pelvic-floor muscles. The lower current amplitudes required also suggest that greater increases in pressure might be obtained with the D2 placement by increasing the current amplitude while remaining within the comfort threshold. These results will help to define treatment guidelines for a planned clinical study investigating the effects of NMES and exercise in the treatment of urinary stress incontinence in women postpartum.

Key Words: Bipolar technique • Electrode position • Interferential currents • Pelvic-floor electrostimulation • Vaginal pressure probe

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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

Chantale Dumoulin, Derek E Seaborne, Cécile Quirion-DeGirardi, and S John Sullivan
Physical Therapy 1995 75: 1075-1081. [Abstract] [PDF]