Abrams P, Cardozo L, Fall M The standardisation of terminology of lower urinary tract function: report from the Standardisation Sub-committee of the International Continence Society. Neurourol Urodyn. 2002; 21:(2)167-178

Aoki Y, Brown HW, Brubaker L, Cornu JN, Daly JO, Cartwright R. Urinary incontinence in women. Nat Rev Dis Primers. 2017; 3

Berghmans B, Hendriks E, Bernards A, de Bie R, Omar MI. Electrical stimulation with non-implanted electrodes for urinary incontinence in men. Cochrane Database Syst Rev. 2013; (6)

Bø K. Pelvic floor muscle strength and response to pelvic floor muscle training for stress urinary incontinence. Neurourol Urodyn. 2003; 22:(7)654-658

Bussel B. History of electrical stimulation in rehabilitation medicine. Ann Phys Rehabil Med. 2015; 58:(4)198-200

Castro RA, Arruda RM, Zanetti MRD, Santos PD, Sartori MGF, Girão MJBC. Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao Paulo). 2008; 63:(4)465-472

Chêne G, Mansoor A, Jacquetin B Female urinary incontinence and intravaginal electrical stimulation: an observational prospective study. Eur J Obstet Gynecol Reprod Biol. 2013; 170:(1)275-280

Cleveland Clinic. Pelvic floor dysfunction. 2017. (accessed 25 July 2019)

Correia GN, Pereira VS, Hirakawa HS, Driusso P. Effects of surface and intravaginal electrical stimulation in the treatment of women with stress urinary incontinence: randomized controlled trial. Eur J Obstet Gynecol Reprod Biol. 2014; 173:113-118

Department of Health and Social Care. National schedule of reference costs: 2015-16. 2016. (accessed 25 July 2019)

Diokno AC, Sand PK, Macdiarmid S, Shah R, Armstrong RB. Perceptions and behaviours of women with bladder control problems. Fam Pract. 2006; 23:(5)568-577

Faiena I, Patel N, Parihar JS, Calabrese M, Tunuguntla H. Conservative management of urinary incontinence in women. Rev Urol. 2015; 17:(3)129-139

Fürst MCB, Mendonça RR de, Rodrigues AO, Matos LL de, Pompeo ACL, Bezerra CA. Long-term results of a clinical trial comparing isolated vaginal stimulation with combined treatment for women with stress incontinence. Einstein (Sao Paulo). 2014; 12:(2)168-174

Heidland A, Fazeli G, Klassen A Neuromuscular electrostimulation techniques: historical aspects and current possibilities in treatment of pain and muscle wasting. Clin Nephrol. 2013; 79:S12-23

Herbert J. The principles of neuromuscular electrical stimulation. Nurs Times. 2003; 99:(19)54-55

Herbison GP, Dean N. Weighted vaginal cones for urinary incontinence. Cochrane Database Syst Rev. 2013; (7)

Indrekvam S, Hunskaar S. Side effects, feasibility, and adherence to treatment during home-managed electrical stimulation for urinary incontinence: a Norwegian national cohort of 3198 women. Neurourol Urodyn. 2002; 21:(6)546-552

Knutson JS, Fu MJ, Sheffler LR, Chae J. Neuromuscular electrical stimulation for motor restoration in hemiplegia. Phys Med Rehabil Clin N Am. 2015; 26:(4)729-745

Lawrence JM, Lukacz ES, Nager CW, Hsu J-WY, Luber KM. Prevalence and co-occurrence of pelvic floor disorders in community-dwelling women. Obstet Gynecol. 2008; 111:(3)678-685

Lúcio A, D'ancona CAL, Perissinotto MC, McLean L, Damasceno BP, de Moraes Lopes MHB. Pelvic floor muscle training with and without electrical stimulation in the treatment of lower urinary tract symptoms in women with multiple sclerosis. J Wound Ostomy Continence Nurs. 2016; 43:(4)414-419

National Institute for Health and Care Excellence. Urinary incontinence in women. Quality statement 4: supervised pelvic floor muscle training. 2015. (accessed 25 July 2019)

National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management. NICE guidance NG123. 2019. (accessed 25 July 2019)

NHS England. Excellence in continence care. Practical guidance for commissioners, and leaders in health and social care. 2018. (accessed 25 July 2019)

NHS Improvement, NHS England. Extension of pause to the use of vaginal mesh. 2019. (accessed 25 July 2019)

NHS website. Overview: urinary incontinence. 2016. (accessed 25 July 2019)

Pelvic Obstetric and Gynaecological Physiotherapy. The pelvic floor muscles—a guide for women. 2015. (accessed 25 July 2019)

Pelvic Obstetric and Gynaecological Physiotherapy. Promoting continence with physiotherapy. 2017. (accessed 25 July 2019)

Pelvic Obstetric and Gynaecological Physiotherapy. Safety and best practice in neuromuscular electrical stimulation for pelvic floor muscle dysfunction. 2019. (accessed 25 July 2019)

Royal College of Nursing. Types of incontinence. 2016. (accessed 25 July 2019)

Sand PK, Richardson DA, Staskin DR Pelvic floor electrical stimulation in the treatment of genuine stress incontinence: a multicenter, placebo-controlled trial. Am J Obstet Gynecol. 1995; 173:(1)72-79

Veldman MP, Gondin J, Place N, Maffiuletti NA. Effects of neuromuscular electrical stimulation training on endurance performance. Front Physiol. 2016; 7

The role of neuromuscular electrical stimulation in the rehabilitation of the pelvic floor muscles

08 August 2019
Volume 28 · Issue 15


Pelvic floor dysfunction is a common problem, particularly for women. A weakness in the pelvic floor muscles can lead to one or more disorders developing, such as urinary incontinence or a pelvic organ prolapse. To combat this, it is advised that the pelvic floor muscles are exercised to strengthen them and help them become more supportive. However, more than 30% of women are unable to detect their pelvic floor muscles to produce an effective contraction. The introduction of neuromuscular electrical stimulation (NMES) in pelvic healthcare poses a significant benefit in the rehabilitation of the pelvic floor muscles.

Neuromuscular electrical stimulation (NMES) involves using an electrical impulse or signal to elicit a muscle contraction (Knutson et al, 2015). Also known as electrical muscle stimulation (EMS) or electromyostimulation, NMES can be used to:

The application of electricity in rehabilitation is not new (Heidland et al, 2013). Live electric fish were studied as an analgesic in around 201 BC by the Greek physician Galen. Some 2000 years later, Genevan physics professor Jean Jallabert used electrical currents in a clinical environment to enhance the quality of the extensor muscles in one patient's forearm, improving movement significantly as a result (Bussel, 2015).

In the 21st century, electrical stimulation is used to provide strength training to athletes and aid in muscle rehabilitation. This focus on rehabilitation has gained relevance for those seeking to treat pelvic floor dysfunctions, both in a medical setting and at home.

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