The effect of high-intensity TESLA stimulation (HITS) therapy on pelvic floor electromyography (EMG) and potential clinical implications for use

Abstract

Background

Stress urinary incontinence (SUI) and pelvic organ prolapse (POP) can significantly impact quality of life for affected women. The compliance and tolerability of strategies such as physiotherapy with or without electrical stimulation is variable. Non-invasive, extracorporeal treatments such as High Intensity Tesla (HITS) therapy have become increasingly promoted as an alternative to physiotherapy but the evidence to support HITS^TM is limited.

Objectives

To assess the impact of a short course of 8–10 sessions using HITS^TM on Electromyographic (EMG) activity of pelvic floor muscles (PFMs) and participant’s satisfaction using the HITS^TM chair.

Study Design

Participants utilised the HITS^TM chair, twice a week for 30 min over 4-to-6-weeks (8–10 sessions in total). For each session, the first 10 min was delivered at a frequency of 10 Hz followed by 10 min at 23 Hz and lastly 10 mins at 35 Hz as this has been shown to be optimal for improving PFM strength. Prospective electromyography measurements at rest, maximum voluntary contraction and endurance of nine volunteers were recorded using the MAPLe® device at baseline and after completion of treatments.

Results

Paired t-test showed statistically significant differences for both endurance and maximum voluntary contraction of PFMs when compared to EMG measurements prior to interventions (p = 0.0003 and p = 0.0002 respectively). Hence, this study demonstrated that all participants had improvement in their EMG muscle activity.

Conclusion

The HITS chair can effectively increase PFM strength and may be a useful outpatient treatment to manage patients with pelvic floor dysfunction such as SUI and POP.