What's the difference between pelvic floor biofeedback and stimulation units?

What’s the difference between a pelvic floor biofeedback device and a stimulation machine?

There are two types of units you can use to help improve your internal muscles: pelvic floor biofeedback devices and muscle stimulation units.

Pelvic floor Muscle Stimulation Units

These units are designed to be used at home to artificially stimulate the pelvic floor muscles to work. Electrical impulses are sent from the machine directly to the pelvic floor to mimic the messages that your brain is supposed to send.

These units are ideal for people who really don’t know where their muscles are. Or what they are supposed to do! They are also good for very weak muscles that can only contract a few times before they fatigue. Or muscles that can only muster a very tiny amount of strength.

  • the sensations (a sort of tingly feeling) created by the electrical impulses help your brain to correctly identify the location of your pelvic floor muscles.
  • the machine will stimulate the muscles to work (contract). It is possible to change the settings to favour different parts of the muscle.
  • you can practice joining in with the machine to learn how to contract your muscles without help
  • the machine can help you to ‘hold’ a muscle contraction while you concentrate on learning to breathe and/or move at the same time
  • we usually recommend that you wait until 3 months postnatally before using a stimulation machine.

Examples of stimulation units:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision.  Many specialist physiotherapists, like myself , have units in clinic for you to try out before you buy.

Traditionally the stimulation is delivered by a battery-operated handheld unit with wires to a internal electrode. The price points vary depending on the number of programmes available & the style of the electrode supplied. A new design on the market is Pelviva, which are wireless foam single-use electrodes.

kegel8 tight & tone

The kegel 8 Tight & Tone Electronic Pelvic Toner £98.99 is a simple classic pelvic floor stimulation unit which we  have used in our clinic for many years.  The buttons are large and few! You may prefer to use it with a periform electrode

Neen Pericalm is discreet and easy to use

Neen Pericalm £69 + buy a probe

is often brought in by customers (availabe on amazon). I also find this one easy to follow the instructions and set the programmes.  It is also very small and discreet. You will need to buy a vaginal or anal probe to go with it.

Kegel8 Mother Nuture is also a TENS machine

Kegel 8 Mother Nuture £79.99

Even though it is the cheapest one that Kegel8 offer it has all the programmes you will need, plus doubles up as a TENS machine if you anticipate another delivery.

Nu-tek levator mini

Nu-tek Levator mini continence stimulator.  

 Win-health  supplies our practice.  It is a good stimulator though the buttons and set up are a little fiddly until you understand how it works. I recommend you select the Periform probe (which has a hole in the middle rather than solid) most clients find it more comfortable.

kegel8 Ultra20

Kegel8 Ultra 20 £134

has more programmes & is supplied with the shapely Glide Gold Vaginal Probe

pelviva foam internal electrode

Pelviva £44.95 for starter pack of 3/£214 for 1 month pack x15

Pelviva is a unique product that does not require a handheld unit like those above. It is a disposable single use foam electrode which is activated just before use then delivers 30-min internal stimulation. video here

How to use a stimulation machine: video series

I have a video series for you covering:

  • Which probe is right for you
  • Step by step setting up your machine
  • How to use a pelvic floor stimulation machine for different problems eg stress incontinence, urgency, pain or prolapse or after delivery.
  • FAQs from clinic!

You will see that these videos were created as a project for Kegel8. However, you will find most of the information applies to stimulation machines in general.

These videos will help you understand your condition, as well as how the machines work. Then, you will be able to decide whether a machine would benefit you and which programmes you would choose.

Pelvic floor Biofeedback devices

Generally, we advise that if you can already contract your pelvic floor muscles then you don’t need to do passive stimulation. The majority of women are ready to jump straight in with a biofeedback unit.

Muscles develop quicker by doing ‘active’ exercises where the brain initiates the activity. When you use a biofeedback device to enhance your practice your brain is learning a new skill-set. Your muscles need to perform in every day life even when you are not plugged in to a machine!

  • The action of your muscles contracting is relayed to a machine which “shows” you what you are doing.  There are several different ways this can be done.  Some machines pick up the electrical signal from your muscles while some respond to pressure.  Some give you a visual picture of what you are doing, others beep or vibrate in response to your contraction.
  • These are great to correctly identify your pelvic floor muscles in different positions. They also ensure you are contracting correctly and also help you focus on relaxing fully between contractions
  • See how well your muscles contract and relax. Have targets to aim for to improve strength, endurance and co-ordination.
  • Practice more complicated tasks. Skills you need for real life or your sport.
  • Make exercising a bit more fun (!) and interesting. This will help you to keep up long-term practice (rather like a piece of gym-kit for your pelvic floor!)

 Examples of pelvic floor biofeedback devices:

To be professional, I do not recommend a single specific product or supplier. But I have aimed to narrow down the list of options for  you.  Please do read customer reviews to help you make your decision. Specialist physiotherapists, like myself, have units in clinic for you to try before you buy.

Electrical biofeedback devices:

Peritone EMG biofeedback unit and Simplex EMG biofeedback unit are  the ones we have used in our clinic for many years (same device in different packaging).  

They are effectively two parts.  You place a small internal electrode (called a Periform, which is single person use,  into the vagina. Then put your clothes back on!. Then link your internal device by a cable to the handheld Pelvitone or Simplex unit (we can loan one of these to you).  

When you contract your pelvic floor muscles their electrical activity registers on the screen. This makes the  lights change from orange to green and gives an audible beep.  

You can practice your quick maximum power squeezes seeing how high you can make the lights go. Also, practice keeping the lights green while you cough or try moving your arms or legs. There is also a work/rest function which ‘counts’ the endurance holds for you and tells you your average squeeze score at the end.

These devices are widely available from lots of online sellers +/- £160 (including the Periform).

Pelvic floor training device

Elvie biofeedback

Elvie  updates the design of the traditional units above. It is popular as it has modern smart phone visuals, easy charting & a sense of community amongst users.  

I have one I can show you in clinic but the internal device (the pebble) is the expensive part, and understandably single use only, so I’m afraid you can’t try before you buy.

It is a discreet, attractive, wireless bluetooth pebble-shaped device. This goes inside the vagina. Use an app to turn your phone into the biofeedback monitor/exercise tracker.  No cables between you and the phone but you can’t put knickers back on or the bluetooth can’t connect. It is beautifully packaged and well designed by women. It can be used in the second trimester of pregnancy but is not recommended for the 1st and 3rd trimesters.

Available directly from  Elvie £169 for the pepple device,  the phone app is free. It’s officially available “on prescription” but sadly, I don’t know anyone whose managed to get one this way.

Pressure Biofeedback devices

Kegel 8 Biofeedback Pelvic Trainer Kegel8 are not offering an electrical biofeedback unit in their products any more. They have a product  which uses a pressure system where you squeeze on a larger tube which moves a dial on the hand held unit.  Relatively unsophisticated but an inexpensive option at £79.99

Epi-no Delphine Plus pressure biofeedback can be used in pregnancy

Epi-No Delphine Plus £89.99 This is another non-electrical device, which monitors the amount of squeeze pressure youare creating with your muscle contraction

Though, as with the Kegel 8 Trainer, this is less sensitive than the electrical one the advantage of the Epi-No is that it is  certified for use through your whole pregnancy. It can also be used in the latter part of pregnancy (after 37 weeks) to help to stretch the vaginal opening. A recent study * did not show evidence of a protective effect of the Epi-No device on birth trauma, however, anecdotally many women feel it has helped with their confidence to relax the vaginal opening in preparation for birth.

*Kamisan Atan I, et al. BJOG 2016  Does the Epi_No birth trainer prevent vaginal birth-related pelvic floor trauma? A multicentre prospective randomised controlled trial.

The Vibrance Pelvic Trainer    is a petite internal device which vibrates when you correctly contract your pelvic floor muscles.  The device is  easy to insert but you may need to hold it in position. There are no wires, or external unit, the vibration is felt in the device itself.

This device could also be useful as a ‘bridge’ back to penetrative sex  if you don’t want to use a traditional vibrator. You could practice inserting the trainer at your own pace. You might find the vibration element helpful to re-sensitise your tissues.   They are available directly from www.vibrancepelvictrainer.co.uk  £140.83 with VAT exemption.

This links to a digitally annotated instructional video for Vibrance PFT on youtube:https://www.youtube.com/watch?v=n8IoqefRzTU

Note about VAT exemption

If you have had a problem for more than 3 months you can declare yourself as having a ‘chronic medical condition’ and do not have to pay VAT. There will be a form to complete. This does not apply to the Elvie which is registered as an exercise tracker not a medical device. Not all the online suppliers can offer this service.

Combined Stim & Biofeedback Machines

You can also buy combined units which do both functions. However, these are surprisingly expensive (and a bit fiddly) so if you feel you need both systems I usually suggest you buy two separate simpler units and switch between them.

Lubricating gel

You will need a water-based lubricating gel to help the insertion of the devices. It is also essential to help the electrical devices to operate correctly. A simple, in-expensive, chemist-own or basic brand name is theoretically all you need. However, if you have concerns about ingredients you may prefer an organic version.   Do read my posts about the difference between water-based and oil-based lubricating products.

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Not sure what YOU need?

Get clarity first

If you are not too sure how good your muscles are then before you spend ANY money on a gadget or device I would highly recommend an hour spent with a specialist physiotherapist! Your appointment will be £70-90 outside London.

Our role at physiotherapy is to do an internal assessment of your pelvic floor muscles. We will check how well they are working and teach you how to get the best from them – you may not need any gadgets at all! And if you do we can help you make the best choice for your needs.

Try before you buy

We can loan you both muscle stimulation and biofeedback units to try out at home. To see how well they work for you before you consider buying your own. It is particularly important to consider an individual assessment by a specialist physiotherapist if you are at all worried that your pelvic floor muscles might be too tight rather than too weak.

We can also teach you exercises , which require no equipment at all! We usually combine pelvic floor exercises with appropriate abdominal muscle work as these two areas need to work well together for best support of our internal organs.

Please don’t hesitate to be in touch if you have further questions.

3 thoughts on “What’s the difference between a pelvic floor biofeedback device and a stimulation machine?

  1. VICKIE HICKS says:

    Hi how do I find someone in the Dayton, Oh to Richmond, In, area to help me? I have a ten unit with a probe, but don’t know what other exercizes to go to get the most benefit. Thanks for any help you can give.

    • Amanda Savage says:

      Hi Vickie. I think you are looking for help in the USA? There are Physical Therapists who specialise in pelvic health who you could ask to be referred to. You will find lots of exercises you can do at home in the Pelvic Floor School section of this site too.

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