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Independence and quality of life

Added value for your practice and patients.

INCONTINENCE / GRADE 1-2

AUTHOR: JOHN LUDESCHER, FEBRUARY 2018

HOUSEWIFE, 63 YEARS OLD

  • Stress urinary incontinence for 1 year

The patient was referred by a gynaecologist and diagnosed with stress incontinence grade 1–2, with a request for pelvic floor training.

The patient’s history shows that the patient is frequently, increasingly experiencing the involuntary loss of urine when sneezing, getting in the car, when walking downhill or when walking downstairs. Furthermore, the patient has to get up 2–3 times during the night to go to the toilet.

The patient’s bladder diary also confirms what was previously suspected as an additional case of urge incontinence. Urination 12–14 times a day, amounts of approx. 200 ml.

Following training on how to carry out the independent pelvic floor exercises (which should be done 2–3 times daily), the patient was also informed on strategies to postpone voiding (urge suppression strategies). These should help the bladder improve capacity.

The patient was put forward for the mixed incontinence programme for magnetic field therapy using the magnetic chair to primarily strengthen her pelvic floor muscles, and to improve circulation to the pelvis. The biofeedback training was also used to improve arbitrary control of the pelvic floor and to help visualise controlling the pelvic floor.

The patient informed us that her muscles were left feeling sore and achy.

After four sessions, when the patient came to see us for the fifth time, she informed us that she no longer had to get up during the night and that when walking downhill she no longer suffered from involuntary urine loss!


FEMALE VITALITY / CELLULITE
& LIBIDO

AUTHOR: ACHIM HILLEN, 2016

STEWARDESS

  • 2 children
  • Moderately active

The positive effect on the skin tone had been noted in the first patients, however this was seen as a conditional secondary effect. It was only after younger patients started using PelviPower after giving birth, and started to report improved skin, that a few trials with 'before-after' shots were carried out. Colleagues carried out 'long-term' trials and confirmed the results.

The body-shaping effect was achieved with frequencies of 20-25Hz and improvements in the skin with frequencies over 35Hz.

In this manner, a combination training method resulted from the desired training targets, starting with the hyperaemic effect of PelviPower and ending with a strengthening component to preserve the shape.

Positive effects are not only visible in terms of the shape of the pelvis and legs; increased control and sensitivity of the pelvic floor were also perceived. Some female patients reported a significant increase in libido during sex.


MALE VITALITY / ERECTILE
DYSFUNCTION

AUTHOR: ACHIM HILLEN, 2016

CASE 1: PROGRAMMER, 35 YEARS OLD

Weight-lifter (in recent weeks more intensive training with the leg press)

CASE 2: TAXI DRIVER, 37 YEARS OLD

No exercise

Both patients reported erectile dysfunction which had lasted a few weeks. In case 1, the patient was unable to achieve erection, indicating a hypertonic pelvic floor, while case 2 could not maintain an erection due to a hypotonic pelvic floor. In both cases, high frequencies were used to achieve tonus regulation and increased blood circulation in the area.

The training was started and the intensity was adjusted in stages. The structuring of the frequencies in therapy correlated to the desired outcomes. The hypertonic pelvic floor muscles in case 1 were first gently activated in a low frequency range and then relaxed very intensively with high frequencies. In case 2, the frequency sequence was changed. A preliminary tissue activation with high frequencies first resolved fascial adhesions causing immobility and only afterwards were frequencies between 20-25Hz applied to achieve targeted strong contraction.

After the 7th training session, both patients provided very positive feedback regarding the actual problem.

Another issue that should be noted was the condition of the leg muscles, in particular the shortened adductors and ischiocrural muscles. Due to activities carried out in a seated position and the lack of compensatory movements, these areas were highly shortened. By learning the correct stretching exercises, awareness of the interplay between leg, pelvis and pelvic floor muscles could be explained and was directly implemented by the patient – both in daily exercises and a pronounced focus on stretching during sports.

The good patient compliance was the result of the actual issues and the very rapid training successes after 3.5 weeks.

Case 1 took the training for a second period in order to further increase results in weightlifting, without any further complaints.

With case 2, this led to an understanding of creating a balance between daily stretching exercises and sports, and at the very least during the training period, this was integrated into daily activities.


MALE VITALITY, PROSTATECTOMY

AUTHOR: ACHIM HILLEN, 2016

CARPENTER, 68 YEARS OLD

  • Surgery, 12 prostatectomy with radiation
  • Physically active
  • Problem: nocturnal bed-wetting, wears pads during the day
  • Strongly decreased libido

The patient came for training on the PelviPower 2 years after surgery. At the start of training, a stabbing feeling was reported when passing through the pelvic floor during the training of pelvic floor awareness. However, with the described treatment in the first training session, it was possible to loosen the scarred/adhesive tissue, without any further problems.

 

The patient was very regular with his appointments and quickly noted an increase in libido and slow improvement during the day. He was able to reduce nocturnal visits to the toilet from 4-5 times a night to max. 2 times a night. Through long and intensive training, an acceptable condition was attained and the patient was motivated to continue follow-up treatment. Dependent on the current status, the training could only be conducted on a weekly basis in some cases.

Two setbacks were recorded during the training. Once due to an excessive walk, the other time preparing the garden for winter at very cold temperatures.

It was possible to restore the deterioration in condition caused by the physical overexertion from the walk within 10 days, however, working in cold temperatures caused a longer symptomatic period. In this case, the patient also suffered a pronounced flu-like infection over a longer period, which was unfavourable for the course of training. After complete recovery from the flu-like infection and recommencement of training, the previous improvement was restored.


YOUNG MOTHERS / POSTNATAL

AUTHOR: ACHIM HILLEN, 2016

OFFICE WORKER, 28 YEARS OLD

  • 2 months after childbirth
  • Perineal tear II
  • Not physically active

Directly after birth, incontinence complaints were experienced due to a perineal tear and injuries from the birth process.

After initial training in postnatal exercise classes, the patient became aware of pelvic floor training, but was not very confident in it, and only trained sporadically. At the beginning of the training, the patient reported slight incontinence problems, for example when lifting and carrying the child. She hardly carried out active training, as the incontinence problems had resolved themselves to a certain degree, however recovery had now stagnated. Establishing the coil position revealed multiple areas of pain in the pelvic area. Here, the coil was positioned near the area of pain, the frequency was increased and some time elapsed until the patient reported being pain-free. The pains were reported once in the sacral area, and once pronounced pain was experienced in the vaginal area.

After resolving the pain areas, it was possible to determine and record the coil position normally. Further treatment remained pain-free. The patient gained awareness of the pelvic floor and the possibilities of contractions within the first 2-3 sessions and according to her own reports, was able to carry out postnatal exercises in a much more targeted manner. The first training successes were reported after the 3rd treatment. After the 8th treatment session, the patient was nearly complaint-free.


SPORT / PROPHYLAXIS

AUTHOR: ACHIM HILLEN, 2016

HOUSEWIFE, 46 YEARS OLD

  • 3 children
  • Incontinence complaints for 2 years during sporting activities, lifting, sneezing, tennis, skiing

Even initial treatments produced significantly better sensitisation of the area; the intensities could be increased very quickly and there were no signs of excessive stress. The training went well and the training appointments were kept in an exemplary manner by the patient. However, the patient only realised that an improvement in daily life had taken place following the final discussion with the therapist, namely that no urine had been released during sport activities, in particular during tennis.

This type of success is normal for training with the PelviPower. In a very few cases, significant improvement occurs from one training session to the next. In most patients, the problem gradually recedes and subsides in the patient's life, leaving a secure feeling, allowing the patient to rekindle social contacts. In order to make these changes visible, the therapist should make notes during the introductory consultation. Notes on each training session also provide a good overview of how the training has developed; they also facilitate referrals between therapists and doctors.

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