Dumoulin C, Seaborne D E, Quirion-DeGirardi C, Sullivan S J
Hôpital Ste-Justine de Montréal, Québec, Canada.
Phys Ther. 1995 Dec;75(12):1067-74. doi: 10.1093/ptj/75.12.1067.
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.
Ten continent female volunteers, ranging in age from 20 to 39 years (mean = 27.3, SD = 5.6), were randomly assigned to one of two study groups.
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.
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).
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. [Dumoulin C, Seaborne DE, Quirion-DeGirardi C, Sullivan SJ. 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.
盆底电刺激被用作尿失禁保守治疗的辅助手段。然而，关于最佳刺激盆底肌肉组织的电极放置方式尚无共识。本研究的目的是采用两组交叉设计，比较两种不同的双极电极放置方式，一种由Laycock和Green提出（L2），另一种由Dumoulin提出（D2），在对无尿失禁的女性进行盆底肌肉组织干扰电流电刺激时的效果。
10名年龄在20至39岁之间（平均 = 27.3，标准差 = 5.6）的无尿失禁女性志愿者被随机分配到两个研究组之一。
每个研究组使用两种电极放置方式对盆底肌肉组织进行神经肌肉电刺激（NMES），每组的应用顺序相反。收缩力通过施加在连接压力计的阴道压力探头上的压力（以厘米水柱[cm H2O]为单位）来测量。数据采用双向混合模型方差分析进行分析。
两种电极放置方式之间未观察到压力差异。观察到电流幅度存在差异，D2电极放置方式在压力计上产生最大记录压力所需的电流幅度较小。受试者的主观评估显示，他们更倾向于D2电极放置方式（10名受试者中有7名）。
D2放置方式所需的较低电流幅度就能获得与L2技术相当的记录，这表明对盆底肌肉的刺激更舒适。所需的较低电流幅度还表明，通过在舒适阈值内增加电流幅度，D2放置方式可能会获得更大的压力增加。这些结果将有助于为一项计划中的临床研究确定治疗指南，该研究旨在调查NMES和运动对产后女性压力性尿失禁的治疗效果。[Dumoulin C, Seaborne DE, Quirion-DeGirardi C, Sullivan SJ.盆底康复，第1部分：使用双极干扰电流刺激无尿失禁女性盆底肌肉组织时两种表面电极放置方式的比较。
