Understanding EMG Biofeedback
Application of EMG Biofeedback in Pelvic Floor Muscle Assessment and Training with Nu-Tek EMG ETS STIM Devices
Nu-Tek EMG ETS STIM Devices have been designed by Jim Oliver, formerly of Verity Medical - the makers of NeuroTrac brand of electrotherapy devices - and an expert in EMG and neuromuscular stimulation and all the applications of EMG and neuromuscular stimulation in continence therapy, pelvic floor assessment, pelvic floor rehabilitation, general muscle rehabilitation and pain relief. The aim of the Nu-Tek range is to provide clinicians with an advanced and reliable alternative brand of devices for clinics and for home use, thus, delivering quality, choice and affordability.
Background to EMG ETS STIM
Strong pelvic floor is crucial for prevention of stress incontinence and other types of urinary incontinence.
EMG stands for "electromyography", which means the measurement of muscle activity. Nu-Tek EMG ETS STIM (i.e. Nu-Tek Levator Elite, Nu-Tek Maxi Plus1 and Nu-Tek Maxi Plus2) measure muscle activity in microvolts (µV), whilst measuring the duration of muscle contractions and muscle relaxations in seconds. Nu-Tek System Software for use with the Nu-Tek EMG ETS STIM devices enable data storage and analysis. Nu-Tek Software is capable of storing and analysing data of many thousands of patients. Nu-Tek Software ensures that clinics using Nu-Tek EMG ETS STIM devices utilise their Nu-Tek equipment to its highest potential.
EMG machines can differ from machine to machine and therefore, their readings also can differ. This means that it is not possible to state 100% precisely, what the ‘normal’ measurement for a given muscle is.
However, based on the experience with the Nu-Tek EMG devices, expected measurements and readings are outlined as follows:
Muscle Rest/Work Measurements
Muscle begins to rest, when a reading of 4 µV is shown. The lower the reading - the more relaxed is the muscle state. At the beginning of treatment and often even some weeks later, it may not be possible to achieve such low readings. However, elevated measurements at this early point of the assessment should not give a reason for concern.
Point to consider: When performing the measurements it is important to remember that the body's positioning affects the readings. For instance, activities within the pelvic floor muscles as well as the measurements differ depending on the position – i.e. lying down, sitting or standing. Measurements taken, whilst standing are naturally a little higher than those achieved while sitting or lying down. This is because the muscles are most active, when standing.
Pelvic Muscle readings that can be expected, when exercising Pelvic Floor Muscles in a sitting position:
- Pelvic Muscle at Rest: 3 – 7 microvolts / graded Excellent when below 3 microvolts
- Pelvic Muscle at Work: 12 – 20 microvolts / graded Very Good when higher than 20 microvolts
- Pelvic Muscle Contraction Time: 0.6 – 1 second / graded Very Good when less than 0.6 second
- Pelvic Muscle Release Time: 0.6 – 1 second / graded Very Good when less than 0.6 second
As indicated above, these values can be higher for exercises done while standing up and lower if lying down.
Muscle Contraction Times
Muscle contraction is measured in seconds. The faster the response - the more developed and the faster twitching muscle fibres are. When the onset of contraction is slow (i.e. 1.2 second or more) - most people will achieve a significant improvement with regular pelvic floor exercises.
Muscle Release Times
Muscle release is also measured in seconds. Release time is similar to the muscle contraction time. Release time that is 1.2 second or more will improve with regular pelvic floor exercises.
How often should pelvic floor exercises be conducted?
Using EMG device, such as Nu-Tek Maxi Plus1, conduct 5 rapid contractions and releases - rest for 2 minutes - repeat 5 rapid contractions and releases. This exercise will improve fast twitch muscle fibres.
Rest for 5 minutes. Then set work/rest times for 5 seconds and repeat 5 times.
Rest for 5 minutes. Then repeat as in section 2 above.
Repeat the same as in 1 - 3 sections above later in the day (i.e. exercise pelvic muscles twice daily) for 4 weeks/1 month.
In the second month increase the work/rest times to 10 - 15 seconds with 5 repetitions. This regime will strengthen the muscles and increase endurance.
Continuous Pelvic Floor Exercise Regime
During the second month of exercising, the muscles should feel stronger. The strength should be confirmed by readings/measurements. If results are satisfactory - either continue with daily regime or reduce it to 3 - 4 times per week for 3 months. If subsequently good stable results are achieved, reduce the sessions to 2 - 3 times per week.
Pelvic Floor Health Recommendation
Pelvic floor is of paramount importance to overall health, lifetime continence and good sexual function. We urge everyone who has concerns to consult their healthcare professional for appropriate advice or for further specialist referral.
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- Nu-Tek Levator Elite kit consists of the main control unit, set of 4 self-adhesive skin electrodes 50 x 50 mm, set of 2 self-adhesive skin electrodes 50 x 100 mm, Nu-Tek vaginal probe, conductive lead, reference lead, 1.5V batteries (4 x AA batteries), holding cradle, User Manual in colour, skin electrodes positioning guide sheet and a carry case. Free copy of Women’s Waterworks Curing Incontinence by Dr Pauline Chiarelli. CE mark Medical Device (CE0197). 2 years warranty.
- Nu-Tek Maxi Plus1 Single Channel EMG Biofeedback kit consists of the control unit, set of 4 self-adhesive skin electrodes (50 x 50 mm), Nu-Tek vaginal probe, conductive lead, reference lead, 4 x 1.5V AA batteries, cradle stand, User Manual. Free copy of Women’s Waterworks Curing Incontinence by Dr Pauline Chiarelli. CE mark Medical Device (CE0197). 2 years warranty.
- Nu-Tek Maxi Plus2 kit consists of the Nu-Tek Maxi Plus2 unit, 1 set of 4 self-adhesive skin electrodes (50 x 50 mm), 1 set of 2 self-adhesive skin electrodes (50 x 100 mm), Nu-Tek vaginal probe, 2 conductive leads, 1 reference lead, 4 x 1.5V AA batteries, holding cradle, colour illustrated User Manual with quick start guide, skin electrodes positioning guide sheet and carry case. (CE0197). 2 years warranty on the Nu-Tek Maxi Plus2 unit.
- Nu-Tek System Software kit is supplied complete with the software installation disc and license for 5 activations (i.e. use on 5 PCs), USB cable, User Manual with Quick Start instructions illustrated in colour. CE mark.
VAT exemption is available, when purchased for personal use by people with relevant chronic conditions. VAT relief declaration must be completed online at the time of purchase.