THE PROFESSIONALS SAY | PFX USERS SAY | BIBLIOGRAPHY | STATISTICS

THE PROFESSIONALS SAY (click on name)
	Dr Jo Laycock Pauline Chiarelli, PT Kathe Wallace, PT Jenny Rex, RN G. L. Hosker   Lynne Assad, PT PT Beth Shelley, PT   "PFX. Vaginal and anal pressure biofeedback: it does what it says, it exercises the pelvic floor. Motivates patients who want results, quickly. Peritron. The first and still the best battery operated electronic perineometer. Accurate enough for research and still simple to use in the hospital or community setting." Dr Jo Laycock, Physiotherapist, Culgaith Clinic, UK. "I have used both PFX & Peritron in my practice since their inception and they have provided an immense difference to the practice of Pelvic Floor rehabilitation. PFX has brought the home program within reach of most of my patients and helps women to comply with their prescribed exercise programmes. Both the PFX & Peritron are great and I have no hesitation recommending these devices to women on a program of pelvic floor rehabilitation or to therapists practising within this discipline." Pauline Chiarelli, Physiotherapist, NSW, Australia. "....... the PFX assists patients in performing one of the most difficult exercises to teach, the Kegel exercise". Kathe Wallace, PT, Physical Therapy Resources, WA, USA " Makes the teaching of pelvic floor exercises easier as the patient can visualise their efforts when performing a contraction. Provides biofeedback for the patient which is an essential element in pelvic floor rehabilitation programs." Jenny Rex, Registered Nurse Stoma Therapist - Royal Prince Alfred Hospital NSW Australia "An incredible tool to find and strengthen the 'hidden' pelvic floor. It's fantastic for awareness and motivation, both critical for pelvic floor rehabilitation." Elizabeth M - Physiotherapist, South Coast NSW Australia "The Peritron shows promise as a portable, inexpensive, easy to use manometer that can be used in an out-patient clinic with more objectivity than the educated finger." "Can a Perineometer be Used for Anal Manometry?" G. L. Hosker - Dept. of Urological Gynaecology, St. Mary's Hospital, Whitworth Park, Manchester M13 OJH United Kingdom "As a Physical Therapist who specializes in the treatment of Pelvic Floor dysfunction, I would like to recommend the Pelvic Floor eXerciser/PFX." Lynne A. D. Assad, Physical Therapist, Urology Centre, NH, USA "In my practice, I have found increased compliance with home exercise programs using the PFX". Beth Shelley, Physical Therapist, Rock Valley Physical Therapy, IL, USA
PFX USERS SAY . . .
	Please click on topic of interest: Pelvic Floor Revitalising: Sexual Sensation Initials used for privacy. Original, unsolicited letters are on file. Pelvic Floor Revitalising "Using PFXA definitely keeps me motivated to continue the exercise program. It provides that added boost when I begin to lose interest. It is very satisfying seeing my improvement register on the PFXA". Mrs. C.D. Chippendale - NSW. "The PFX has taught me how to do pelvic floor exercises effectively and with other alternative treatments my prolapse is no longer a problem". Ms. M., South Coast NSW, Australia "The PFX really works - provided you put in time & effort to do the exercises". Ms. H - ACT Australia   Sexual Sensation I would not have believed it if I had read it, but it happened to me. After almost 24 years of being what is commonly called pre-orgasmic, I decided, on the new year, to try to do something about it, and started doing pelvic floor exercises. This had been brought on by a course of anti-depressants I had been prescribed to stop a nerve condition in my face. What the doctor had failed to tell me was that a side-effect of this type of medication is a total deadening of libido. After putting up with this for almost 2 years, my marriage had had enough of this. My mind wanted to feel sexy, I think my husband is sexy, but my body dreaded going to bed. I thought that if I could use my muscles better "down there", I could at least bring some pleasure to my husband, instead of being such a dead duck in mind and body. Well, what!! Within the unbelievable time of three days, we experienced an amazing change. First of all, the dryness that I'd been experiencing from lack of drive, was totally gone. In its place was a luxuriant slipperiness, eliminating even the off putting time-out for bottled lubrication. The exercises also made me, to be blunt, randy. After a very short while they feel good whenever you do them. Especially if you do them listening to music, or just sitting innocently, where no one can tell what you are doing, in which case there is an extra buzz. I have to report that before I knew it I was in the embarrassing state of having multiple orgasms of incredible length. I was suddenly suffering the worry of boring my husband with the fact that they would go on for a half hour or more. I didn't need to be embarrassed. He wasn't bored at all. We haven't looked back. The Cardio PFX is invaluable for doing these exercises, as it is the only way to know that the right muscles are indeed working, and also to know that you are maintaining a hold. It is no good to just momentarily be able to hold. The real skill and lasting benefits come with the control of maintaining a hold and being able to slowly release it. Without the PFX, you can think you are doing something when you are not, or feel that you are stronger than you are. According to the machine's feedback, I am just a rank amateur. From the benefits it has already given me, I can only see more win-win from the only fun muscle exercise/exerciser I have ever known. Except for the one we enjoy with the three letter word. By the way, there is also nothing to be embarrassed about in using it. My husband always has a smile on his face when I take out my box to do my exercises. We both want it to be a daily ritual, and it really should be, as we modern women are not used to using these muscles, and really need the practice. However, it isn't painful in the least. Quite the opposite. Exercise of this sort feels the kind of nice that nice girls shouldn't feel. What a reason to work out! Please use this recommendation in any way you like. I think your company has produced a splendid, remarkably easy-to-use, and affordable device. The only complaint I have is that I didn't find you sooner. As my husband said, "Too bad this didn't happen twenty years ago." Still, he's not complaining. Sincerely, Mrs. T.K. south coast, New South Wales
Bibliography
	Of the vast amounts of material published on pelvic floor rehabilitation by exercise, the few outlines reproduced below summarise the current situation, which seems to be: Pelvic Floor exercises are the treatment of first choice for overcoming conditions attributable to weakened pelvic floor muscles such as urinary stress incontinence and reduced sensation during sexual intercourse. Doing pelvic floor contractions is not instinctive as about 50% of women require instruction. Without feedback exercising the pelvic floor muscles is boring and uncertain. Feedback improves motivation which leads to faster pelvic floor fitness and a higher success rate. 1 The Knack: Use of Precisely-Timed Pelvic Muscle Contraction Can Reduce Leakage in SUI. Janis Miller, James A. Ashton-Miller and John O. L. DeLancey University of Michigan, Ann Arbor, Michigan U.S.A. presented at ICS Conference - Athens 1996 Conclusion/Results:-"The Knack, a precisely-timed volitional LA contraction, learned in one week, is a simple and efficient technique to reduce urine leakage by over 60% during a cough."... 2. The Role of Muscular Re-Education by Physical Therapy in the Treatment of Genuine Stress Urinary Incontinence. L. Lewis Wall and Theresa G. Davidson Dept. Gynaecology & Obstetrics Emory University School of Medicine, Atlanta Georgia Dept. of Therapy, Duke University Medical Centre, Durham, North Carolina. Published - Obstetrical & Gynaecological Survey - Review vol 47, No 5 - 1992 Conclusion:- "From this survey of the literature it is apparent that exercise programs to re-educate and rehabilitate the musculature of the pelvic floor do have a place in the prevention and treatment of genuine stress urinary incontinence. ......... Although objective measurement of outcome remains a problem, it is also very clear that pelvic floor exercise programs work best when close supervision and some form of biofeedback are part of the teaching process". ....... 3. Assessment of Kegel pelvic muscles exercise performance after brief verbal Instruction. Bump R.C. Hurt W. C. Fantl J. A. et al (August 1991). American Journal of Obstetrics and Gynecology, 322-329. "in 47 women, 51% could not produce an effective pelvic floor contraction simply with verbal instructions"   4. The role of biofeedback in Kegel exercise training for stress urinary incontinence. Burgio K. L. Robinson J. C. & Engel B. T. (1986). American Journal of Obstetrics and Gynecology, 154(1), 58-64. 27 women in two groups, one with verbal, one with verbal plus instrument biofeedback. After two sessions per week for four weeks 80% of Biofeedback group reported improved symptoms cf 51% of non biofeedback group. Maintained at six months. Feedback group could maintain stronger contractions. Biofeedback is immediate and continuous Instrument feedback is more precise than verbal feedback Biofeedback is invaluable for increasing motivation and having patients adhere to the exercise program. 5. The Role of Biofeedback in Kegel Exercise Training for Stress Urinary Incontinence Kathryn Larsen Burgio, Ph.D., J. Courtland Robinson, M.D., and Bernard T. Engel Ph. D. - Bethesda and Baltimore, Maryland U.S.A.Published - October 1985 - from Gerontology Research Centre,Baltimore Maryland. Conclusion:- "These findings indicate that biofeedback is more effective than verbal feedback based on vaginal palpation for teaching selective sphincter control. Only the biofeedback group demonstrated increased sphincter strength with training and improved ability to minimise intra-abdominal pressure." ......... 6. Pelvic Floor Re-education in the Management of Incontinence - Jo Laycock PHD MCSP - Urotherapy Manager, Bradford Royal Infirmary - Bradford U.K. Presented for publishing - November 1993 Conclusion/Results:- ......"Patients generally respond best to combination therapy, if this is available. The use of modern technology appears to motivate them and improve their compliance to a daily home exercise programme......" 7. Behavioural Training for Stress and Urge Incontinence in the Community Kathryn L. Burgio, University of Pittsburgh School of Medicine, Pittsburgh P.a. U.S.A Published - Gerontology 1990 : 36(suppl 2) : 27-34 Conclusion:- "Like other treatment modalities for urinary incontinence, biofeedback-assisted behavioural training has distinct advantages and limitations. Foremost among its advantages are its very low risk and the absence of documented side effects..........Considering its effectiveness and the low risk level associated with behavioural training, it should be considered among the first treatments offered to non demented patients with stress or urge incontinence". 8. Effectiveness of Biofeedback therapy for Stress Incontinent Females P.A. Burns, K. Pranikoff, J.S. Reis and K. J. Levy The State University of New York - Buffalo New York U.S.A. Abstract 82 - Presented at ICS Conference - Oslo Norway - September 1988 Conclusion/Results:- "The results of this single blinded controlled trial appear to demonstrate the effectiveness of an adjunctive behavioural therapy for treatment of stress incontinence." 9. The Effect of Post Natal Exercises in the treatment of Urinary Incontinence Siv Morkved MSc PT* - Kari Bo PhD PT** *Sor - Trondelag College Trondheim Norway **Centre for Physiotherapy Research Oslo Norway presented at ICS Conference - Athens 1996. Conclusion:- "The results indicate that a specially designed pelvic floor muscle exercise course is effective in increasing pelvic floor muscle strength and to reduce urinary incontinence post-natally." .......... 10. The Effect of a First Delivery on the Integrity of Pelvic Floor Musculature K. Marshall * , D.M. Walsh# and G.D. Baxter# * Rotunda Hospital and # University of Ulster, Ireland presented at ICS Conference - Athens 1996. Conclusion:- ".....it would appear advisable that all women must have a tailor made programme of pelvic floor rehabilitation exercises after childbirth"........ 11. Pelvic Floor Re-education (Principles and Practice) B. Schussler, J. Laycock, P. Norton and S.Stanton In print 1999 Conclusion:- "The studies described have demonstrated the benefit of biofeedback as an adjunct to PFE in the re-education of the PFM.".....
STATISTICS
	Incontinence in Men Incontinence in Women There are many hundreds of references on this topics. The following are typical: Incontinence in Men refer to www.poise.com/incont_educ_center/male_incont/ Urinary Incontinence after Prostatectomy: Nearly 50% of patients with a prostatectomy experience stress incontinence which is related to anal sphincter malfunction Exercises 'top up' the natural healing process. During healing, men should learn to consciously 'tighten up' prior to exertion. A third of patients still have leakage 12 months after the operation. Incontinence in Women Prevalance of urinary incontinence in study of 41,724 Australian women: 13% @ age 18-22 sample size 14,761 36% @ age 45-49 sample size 14,070 35% @ age 70-74 sample size 12,893 with 'marked increase' post partum. Chiarelli and Brown, Neurology and Urodynamics 18:567-577 (1999). 50% of the 75,000 residents in Australian nursing homes are 'wet'. 70% of residents are women. Prof R Millard 1985. Continence Foundation of Australia. Pelvic Floor exercise programs (without feedback) have a drop rate of 20-30%. Wilson 1997 In a population of 549 nulliparus women ave 29yrs, incidence of Urinary incontinence was 3.6% pre birth, 43.7% at 34 weeks, 14.6% at 3 months after birth. St Georges Hospital London, Anne Hosp, Southhampton, Mayday University Hosp, Surrey UK. 1999 Obstet Gynecol 1999;94:689-94 American College of Obs and Gynec 'It is conservativly estimated that people with incontinence .... spend in excess of $1,200 per year on hygiene maintenance and appliances' Continence Foundation of Australia 1997 Interview of 100 women concluded that 17% of women over 45 affected by incontinence. 48% of these expressed dissatisfaction with the treatment Bladder Health Council of the American Foundation for Urological disease 'as many as 25m Americans significantly affected by chronic incontinence'. National association for Incontinence (NAFC) March 96