============================================================
STATISTICAL REVIEW
FOR AMS FREEDOM CENTERS
PREPARED: NOVEMBER 2, 1995
Michael I. Williams, Director/C.E.O.
Patricia Kaczmarek, R.N., Clinical Director
Advantage Medical Services, Inc.'s patients were seen at AMS Freedom Centers located in Bradenton, Orlando, Sun City Center, Sarasota and West Palm Beach, Florida. The following statistics reflect the actual results of our combined state-wide group practice for the treatment of urinary incontinence fecal incontinence, chronic constipation and pelvic floor dysfunction. AMS currently has over 200 referring physicians who are pleased with the success our comprehensive program has consistently produced with their patients.
To prospectively evaluate a treatment program for a range of pelvic floor dysfunctions incorporating Behavioral Techniques including; bladder training, habit training, behavioral modification, prompted voiding, and pelvic floor muscle exercises utilizing ElectroMyoGraph - EMG Biofeedback to evaluate, isolate and retrain the pelvic floor muscles .
From Sept. 1993 to Sept. 1995 patients were referred for treatment of pelvic floor dysfunctions by their physician, who after a physiologic evaluation determined EMG Biofeedback was an appropriate choice of treatment. A team approach of the referring physician, our medical directors and our specially trained registered nurse were continuously involved for the length of treatment. Weekly EMG Biofeedback sessions were performed with a EMG PerryAnal™ or PerryVaginal™ sensor attached to an Orion/Perry biofeedback system. Our protocol utilizes the second channel of EMG to isolate the pelvic floor muscles from the abdomen and other accessory muscles insuring the patient is performing the Kegel exercises correctly. In addition, patients were given a personal sensor and a tape for home exercises. At each session, the therapist reviewed the progress and required documentation with the patient, performed an EMG evaluation, determined the therapy goals and treatment plan, performed EMG assisted Kegel exercises, reviewed and planned behavioral modifications and the individuals therapy goal.
Our clinical experience demonstrates if less than 8 visits are performed, the patient has not given the therapy program a sufficient opportunity to be effective. Therefore, if a patient subjectively reported less than a 50% improvement and had less than 8 visits, the patient was not included in the statistical data.
183 patients with chronic constipation and/or fecal incontinence as the primary diagnosis completed therapy (129 Females =70% and 54 Males =30% with an average age of 71.8 years). The average treatment was 7.6 visits with a range from 3 - 14 visits. The results as reported subjectively by the patients was 87.8% improvement. The average weekly unassisted and complete evacuation was .8 per week at the start of therapy and 6.5 per week upon completion of therapy. This is a 661% increase in bowel movements per week. The average weekly fecal accidents was 11.7 per week at the start of therapy and 1.8 per week upon completion of therapy. This is a 501% decrease in fecal accidents per week. The average net strength increase of the patients is 43%.
Of the 183 patients, 71 patients (39%) also reported urinary incontinence. Of the 183 patients, 171 (93%) subjectively reported over a 70% improvement with 64 patients (35%) reporting 100% improvement, 52 patients (28%) reporting 90 - 99% improvement, 28 patients (15%) reporting 80 - 90% improvement and 27 patients (15%) reporting 70 - 80% improvement.
173 patients with urinary incontinence as the primary diagnosis completed therapy (143 Females =83% and 30 Males =17% with an average age of 74.2 years). The average treatment was 8.7 visits with a range from 3-15 visits. The results as reported subjectively by the patients was 88.3% improvement. The average weekly urinary accidents was 20.0 per week at the start of therapy and 2.7 per week upon completion of therapy. This is a 643% decrease in urinary accidents per week. The average net strength increase of the patients is 34%.
Of the 173 patients, 73 patients (42%) also reported chronic constipation or fecal incontinence. Of the 173 patients, 166 (96%) subjectively reported over a 70% improvement with 43 patients (25%) reporting 100% improvement, 70 patients (40%) reporting 90 - 99% improvement, 28 patients (16%) reporting 80 - 90% improvement and 25 patients (14%) reporting 70 - 80% improvement.
Behavioral Techniques utilizing EMG Biofeedback is a very effective treatment modality for urinary incontinence, fecal incontinence and chronic constipation. The patient must have a sufficient motivation to cooperate with their healthcare team and follow their therapist's instructions in order to achieve the high degree of success reported.
For more information regarding Advantage Medical Services, Inc. please contact Michael I. Williams, C.E.O. or Patricia Kaczmarek, R.N., Clinical Director at the Corporate Offices located at 3300 26th Street West Bradenton, Florida 34205 or call 1-941-755-1200
Webmaster's Note: A version of this report was presented as a poster at the AAPB meeting in Albuquerque in March, 1996.
© 1995 by Advantage Medical Services, Inc.
This page is http://www.incontinet.com/articles/amsword.htm
To return to our home page, click
here.