Effect of intravaginal vibratory versus electric stimulation on the pelvic floor muscles: A randomized clinical trial

Abstract

Effect of intravaginal vibratory versus electric stimulation on the pelvic floor muscles: A randomized clinical trial Marina P. Rodriguesa,*, Lia J.F. Barbosaa, Luciana L. Paivab, Suzana Mallmanna, Paulo R.S. Sanchesc, Charles F. Ferreiraa,d, José G.L. Ramosa a Graduate Program in Health Sciences: Gynecology and Obstetrics. Hospital de Clínicas de Porto Alegre. School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil b Undergraduate Program in Physiotherapy, School of Physical Education, Physiotherapy and Dance, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil c Research and Development Service in Biomedical Engineering, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil d Climacteric and Menopause Research Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil A R T I C L E I N F O Article history: Received 15 November 2018 Received in revised form 19 March 2019 Accepted 16 April 2019 Available online 12 May 2019 Keywords: Vibration Electric stimulation Physical therapy Pelvic floor A B S T R A C T Introduction: According to the International Urogynecological Association and International Continence Society people with normal pelvic floor muscle function should have the ability to voluntarily and involuntarily contract and relax these muscles. However, many women are unaware of their pelvic floor, and it is estimated that about 30–50% do not know how to actively contract these muscles. Within this context, therapeutic strategies to improve pelvic floor muscle strength and function are particularly relevant. Aims: To compare the use of an intravaginal vibratory stimulus (IVVS) versus intravaginal electrical stimulation (IVES) on pelvic floor muscle functionality in women with pelvic floor dysfunctions who cannot voluntarily contract these muscles. Materials and methods: Randomized clinical trial performed at a tertiary care hospital from June 2016 to September 2017. The sample comprised adult women with pelvic floor dysfunction who were unable to contract their pelvic floor muscles voluntarily. Women with latex allergy or other allergies in the pelvic region, vaginal or urinary tract infection, gynecological cancer, significant pain on palpation, or pelvic floor training over the preceding 6 months were excluded. After baseline assessment, women that met the inclusion criteria were randomized to receive once-weekly 20-minute sessions of IVVS or IVES for 6 weeks. Results: Twenty-one women were randomly assigned to each group; 18 completed the IVVS and 17 completed the IVES protocols. The IVVS group presented a significant increase in PFM strength in relation to the IVES group (p = 0.026). There was a significant interaction between time and type of intervention for the same variable (p = 0.008) in the IVVS group. Conclusion: Both techniques were beneficial, but IVVS was significantly superior to IVES in improving pevic floor muscle strength. Additional studies are warranted to consolidate the utility of IVVS as a treatment modality for pelvic floor dysfunction.