The Handbook of EMG Perineometry
[was] Published by
Biotechnologies, Inc.
Strafford, PA 19087
and
Farrall Instruments, Inc.
Grand Isle, NE 68802
We acknowledge with gratitude the feedback from hundreds of Electronic Perineometer™ users to
earlier editions of this Instruction Manual. Special Thanks to William E. Whitehead, PhD, of The
Johns Hopkins University School of Medicine for critical comments and suggestions.
Handbook of EMG Perineometry
Jump to Table of Contents
Historical Note:
This Handbook of Perineometry was published with annual revisions from 1982 to 1987 and distributed as part of the FDA labeling with the "vaginal myograph" invented by Dr. John Perry and manufactured by Farrall Instruments. In this manual Dr. Perry attempted to consolidate what had been learned about the treatment of pelvic muscle dysfunctions by EMG biofeedback by dozens of practitioners through the country and several European and South American countries. During this period the pink, dental-acrylic Perry™ sensor was the only pelvic muscle sensor available for this therapy. Only towards the end of this period did AIDS become a major concern, resulting in the introduction of the "Single-User Sensor" in 1989.
During the first five years (1981-1986), this new therapy was used primarily to treat sexual dysfunctions, especially anorgasmia in females, although there were a large number of urinary incontinence patients as well. In 1985 Dr. Perry moved to Philadelphia and helped Lesley Hullett, RN, form the Biofeedback Institute of Philadelphia; and urinary incontinence quickly became their primary focus. In 1986 the "Perineometer Research Institute" (later known as "The Perry Institute") was formed and in November, 1986 the first Training Seminar was held, using a 2-Day format. Diane Smith, RN, who was later to form "Golden Horizons" with Diane Newman, was primarily responsible for teaching "urinary incontinence" on the first day, and John Perry, PhD, taught "sexual dysfunctions" on the second day. Katherine Jeter, founder of HIP, Inc., was one of the first students.
By early 1987 it became apparent that the demand for Perineometry to treat urinary incontinence was much greater than the demand for sexual therapy, and the emphesis shifted accordingly. In addition, a demonstration project at Paoli Memorial Hospital and an NIH-SBIR grant helped "PRI" refine protocols for the treatment of urinary incontinence. The "Handbook" continued to be distributed by the sensor's manufacturer, Farrall Instruments, but new material was presented and refined in the seminars taught by Perry and Hullett over a period of eight years. [We hope to present that material on-line beginning in the near future; see a link to information on our home page.]
The Text of the 1987 edition of the Handbook is presented here for the benefit of those who never attended our seminars and are waiting patiently for the on-line version, as well as those who may have lost or misplaced an original dead-tree edition of the Handbook.
This chapter applies ONLY to the sterilizable, re-useable Perry brand sensors made of pink denture acrylic. These sensors are no longer marketed, for safety and liability reasons. Today all vaginal and rectal sensors, regardless of manufacturer, are FDA registered for single patient use only! There are, however, hundreds of these old style sensors still in use, and users should exercise extreme caution in following proper procedures in their sterilization. Even so, it would be wise to consider switching to the new Single-User Sensors.
This is the heart of the manual, and contains much practical advice that is still very current and useful. It was written to be used with any manufacturer's EMG system, because in the early days most incontinence work was done by biofeedback practitioners who already owned EMG instruments and were branching out into pelvic muscle work. A data-collection chart is included to fascilitate recording work-rest cycles with instruments which do not have work-rest as a built-in feature.
The world's first computerized system for pelvic muscle rehabilitation was written in the summer of 1985 (on the beach at Stone Harbor, New Jersey!) for a Commodore C-64 computer and the J&J I-300 interface. It translated the features of the Clinical Perineometer (next item) into a computerize and modifiable format. Many of these Commodore-based systems are still in use at Continence Clinics around the country. Because it was difficult for hospitals to obtain C-64 computers, and very easy for them to obtain IBM computers at huge discounts over retail, the next item, the IBM program, was developed. Eventually, as C-64s were getting harder to find, the unique features of this popular program (such as bright "fill graphs" and stylized printouts) were incorporated into the Orion/Perry Teacher cartridge for the Orion 8600 by Self Regulation Systems.
By 1987 the "PC Revolution" was well underway, in biofeedback as well as in the business and professional world. The J&J I-330 Interface quickly became the new world-wide standard in computerized biofeedback, largely because of (1) its tremendous capacity to program, save and circulate protocols, which were called "applications", and (2) its relatively inexpensive price [about $3,500, compared with some $10,000 for a non-programable "Biocomp", the other industry leader.] This chapter is mostly of historical interest, since the latest (1996) version of the manual is also available on this website as SW-330.
The CP-400 was a "transportable" version of the original CP-100, a wooden-cased hard-wired biofeedback instrument specifically designed to automate and standardize the evaluation and training of pelvic muscles. Called the "Clinical Perineometer", it was first sold in 1981 to an Ob/Gyn clinic in Chicago, with dozens more to follow. It was able to capture "flick" scores (peaks), conduct a 10-second "hold" test, and even count seconds for the Endurance Test. But the most impressive feature was the built-in paper "Strip Chart" which recorded the integrated EMG much like an EKG strip chart. The similarity was not accidential; it was intended to convince medical personnel that pelvic muscle training was serious medical treatment. It apparently worked.
This is the Instruction Manual which accompanied the "PP-200" pelvic muscle home trainer. Although it is no longer in production, there are several hundred still in use, many in rental programs. Download this file if you've lost your original manual, which is no longer in print.
This is a patient hand-out designed to educate and encourage the patient in at-home exercises with the home trainer. It explains the rationale for Kegel exercises, the importance of keeping records of progress, and offers other helpful suggestions. It may be used effectively with any brand of EMG home trainer to supplement their "general" instrument instructions with "pelvic muscle" related information.
(This chapter was never completed.)
(This chapter was never completed.)
This chapter was published separately in an 8-1/2 x 11 inch format. It is not included here because it consisted of full-page graphics with captions, and because permission to use certain copyrighted materials was never obtained. (CIBA's prices for use of Netter's drawings is VERY high. If anyone wants to make an educational grant, we'll resume this project!)
This page is http://incontinet.com/articles/art_urin/HOPTOC.htm
Hypertext version ©1996 by John D. Perry
Use your browser's back-arrow key to return to the previous page.
Click Here to return to our home page.