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Functional Electrical Stimulation (functional + electrical_stimulation)

Distribution by Scientific Domains

Medical Sciences	86%

Selected Abstracts

Cortical and subcortical correlates of functional electrical stimulation of wrist extensor and flexor muscles revealed by fMRI

HUMAN BRAIN MAPPING, Issue 3 2009
Armin Blickenstorfer
Abstract The main scope of this study was to test the feasibility and reliability of FES in a MR-environment. Functional Electrical Stimulation (FES) is used in the rehabilitation therapy of patients after stroke or spinal cord injury to improve their motor abilities. Its principle lies in applying repeated electrical stimulation to the relevant nerves or muscles for eliciting either isometric or concentric contractions of the treated muscles. In this study we report cerebral activation patterns in healthy subjects undergoing fMRI during FES stimulation. We stimulated the wrist extensor and flexor muscles in an alternating pattern while BOLD-fMRI was recorded. We used both block and event-related designs to demonstrate their feasibility for recording FES activation in the same cortical and subcortical areas. Six out of fifteen subjects repeated the experiment three times within the same session to control intraindividual variance. In both block and event-related design, the analysis revealed an activation pattern comprising the contralateral primary motor cortex, primary somatosensory cortex and premotor cortex; the ipsilateral cerebellum; bilateral secondary somatosensory cortex, the supplementary motor area and anterior cingulate cortex. Within the same subjects we observed a consistent replication of the activation pattern shown in overlapping regions centered on the peak of activation. Similar time course within these regions were demonstrated in the event-related design. Thus, both techniques demonstrate reliable activation of the sensorimotor network and eventually can be used for assessing plastic changes associated with FES rehabilitation treatment. Hum Brain Mapp, 2009. © 2008 Wiley-Liss, Inc. [source]

Functional Electrical Stimulation-Supported Interval Training Following Sensorimotor-Complete Spinal Cord Injury: A Case Series

NEUROMODULATION, Issue 3 2009
Jack Crosbie PhD
ABSTRACT Objective.,To investigate the effect of interval training supported by Functional Electrical Stimulation (FES) on ambulation ability in complete spinal cord injury (SCI). Methods.,We trained four men with sensorimotor-complete (ASIA A) SCI, who achieved gait through FES of the quadriceps femoris, gluteus maximus, and common peroneal nerve on each side on a motorized treadmill. Training involved progressive interval walking exercise, consisting of periods of activity followed by equal periods of rest, repeated until muscle fatigue. We used time to muscle fatigue during continuous treadmill ambulation as the primary outcome measure. We also recorded the patterns of incremental stimulation for all training and testing sessions. Results.,All subjects increased their ambulation capacity; however, the responses varied from subject to subject. Some subjects increased the total distance walked by as much as 300% with progressive improvement over the entire training period; however, others made more modest gains and appeared to reach a performance plateau within a few training sessions. Conclusions.,FES-supported interval training offers a useful and effective strategy for strength-endurance improvement in the large muscle groups of the lower limb in motor-complete SCI. We believe that this training protocol offers a viable alternative to that of continuous walking training in people with SCI using FES to aid ambulation. [source]

Real Time Foot Drop Correction using Machine Learning and Natural Sensors

NEUROMODULATION, Issue 1 2002
Morten Hansen MScEE
Abstract The objective of this study was to investigate and test a real time system implemented for Functional Electrical Stimulation (FES) assisted foot drop correction, deriving control timing from signals recorded from a peripheral sensory nerve. A hemiplegic participant was attached with a cuff electrode on the sural nerve connected to a telemetry controlled implanted neural amplifier, and a stimulation cuff electrode on the peroneal nerve connected to an implanted stimulator. An input domain was derived from the recorded electroneurogram (ENG) and fed to a detection algorithm based on an Adaptive Logic Network (ALN) for controlling the timing of the peroneal stimulation. The detection system was tested in real time over a period of 392 days, covering a variety of walking tasks. The detection system's ability to detect heel strike and foot lift without errors and to detect the difference between walking and standing proved to be stable for the duration of the study. We conclude that using ALNs and natural sensors provide a stable and accurate control signal for FES foot drop correction. [source]

Functional Electrical Stimulation: A New Horizon For Quadriplegic Patients

ANZ JOURNAL OF SURGERY, Issue 8 2000
Claudia R. Gschwind
No abstract is available for this article. [source]

Welcome to the 10th Vienna International Workshop on Functional Electrical Stimulation

ARTIFICIAL ORGANS, Issue 8 2010
Winfried Mayr PhD
No abstract is available for this article. [source]

Abstracts from the 10th Vienna International Workshop on Functional Electrical Stimulation and the 15th Annual Conference of the International FES Society

ARTIFICIAL ORGANS, Issue 8 2010
Article first published online: 4 AUG 2010
First page of article [source]

Clinical Practice of Functional Electrical Stimulation: From "Yesterday" to "Today"

ARTIFICIAL ORGANS, Issue 8 2008
Milan R. DimitrijevicArticle first published online: 18 AUG 200
Abstract:, Functional electrical stimulation (FES) is an accepted treatment method for paresis or paralysis after spinal cord and head injury as well as stroke and other neurological upper motor neuron disorders. At the beginning, FES worked like an electrophysiological brace for the correction of drop foot of patients after a stroke. When analyzing early accomplishments, it becomes evident that FES was influenced rather by technological and biomedical engineering development than by contemporary knowledge on neurocontrol of movement in individuals with upper motor neuron paralysis. Nevertheless, with better understanding of pathophysiology of spasticity and neurocontrol of impaired movement, FES advanced from an electrophysiological brace to a treatment modality for the improvement of muscle control, neuroaugmentation of residual movements, and supportive procedure for "spontaneous recovery" of motor control. In the present article we shall illustrate barriers which delayed FES to be applied in clinical practice of neuron rehabilitation from "Yesterday" to "Today." We shall discuss the importance to apply FES early after the onset of neurological conditions to prevent disuse of noninjured portions of the CNS. Moreover, FES can play a significant role in the supporting processes of neuroplasticity in the subacute phase of upper motor neuron dysfunction. Therefore, the electrophysiological brace of "Yesterday" provides "Today" a correction of missing neuromuscular function. At the same time, it is an active external device for the correction of motor deficits interacting with the somatosensory-motor integration. Thus, "Yesterday" and "Today" of the same technological approach can be very different, thanks to a different understanding and assessment of "external" and "internal" components of human motor control. [source]

On the Occasion of the 9th Vienna International Workshop on Functional Electrical Stimulation

ARTIFICIAL ORGANS, Issue 8 2007
Winfried Mayr PhD
No abstract is available for this article. [source]

Additional Contributions From the 8th Vienna International Workshop on Functional Electrical Stimulation

ARTIFICIAL ORGANS, Issue 6 2005
Winfried Mayr PhD
No abstract is available for this article. [source]

The Spectrum of FES Applications Is Growing,Selected Topics from the Recent 8th Vienna International Workshop on Functional Electrical Stimulation

ARTIFICIAL ORGANS, Issue 3 2005
Winfried Mayr PhD
No abstract is available for this article. [source]

On the Occasion of the 8th Vienna International Workshop on Functional Electrical Stimulation

ARTIFICIAL ORGANS, Issue 8 2004
Winfried Mayr PhD Guest Editors
No abstract is available for this article. [source]

Therapeutic effects of functional electrical stimulation of the upper limb of eight children with cerebral palsy

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2000
P A Wright BSc PhD
Functional electrical stimulation (FES) of the upper limb has been used for patients with a variety of neurological conditions, although few studies have been conducted on its use on the upper limb of children with cerebral palsy (CP). The aim of this study was to investigate the effect of cyclic FES on the wrist extensor muscles of a group of eight children (five boys, three girls) with hemiplegic CP (mean age 10 years). The study design involved a baseline (3 weeks), treatment (6 weeks), and follow-up (6 weeks). FES was applied for 30 minutes daily during the treatment period of the study. Improvements in hand function (p,0.039) and active wrist extension (p=0.031) were observed at the end of the treatment period. These improvements were largely maintained until the end of the follow-up period. No significant change was observed in the measurements of wrist extension moment during the treatment period (p=0.274). Hand function in this group of children improved after they were exposed to FES of wrist extensor muscles. This suggests that FES could become a useful adjunct therapy to complement existing management strategies available for this patient population. [source]

Considerations for pacing of the cricoarytenoid dorsalis muscle by neuroprosthesis in horses

EQUINE VETERINARY JOURNAL, Issue 6 2010
N. G. DUCHARME
Summary Reasons for performing study: The success rate of prosthetic laryngoplasty is limited and may be associated with significant sequelae. Nerve muscle pedicle transplantation has been attempted but requires a year before function is restored. Objective: To determine the optimal parameters for functional electrical stimulation of the recurrent laryngeal nerve in horses. Methods: An experimental in vivo study was performed on 7 mature horses (2,21 years). A nerve cuff was placed on the distal end of the common trunk of the recurrent laryngeal nerve (RLN). In 6 horses the ipsilateral adductor branch of RLN was also transected. The electrodes were connected to programmable internal stimulator. Stimulation was performed using cathodic phase and then biphasic pulses at 24 Hz with a 0.427 ms pulse duration. Stimulation-response experiments were performed at monthly intervals, from one week following implantation. The study continued until unit failure or the end of project (12 months). Two of the horses were stimulated continuously for 60 min to assess onset of fatigue. Results: Excellent arytenoid cartilage abduction (mean arytenoid angle of 52.7°, range 48.5,56.2°) was obtained in 6 horses (laryngeal grades I or II (n = 3) and III (n = 2). Poor abduction was obtained in grade IV horses (n = 2). Arytenoid abduction was maintained for up to a year in one horse. Technical implant failure resulted in loss of abduction in 6 horses at one week to 11 months post operatively. Mean tissue impedance was 1.06 kOhm (range 0.64,1.67 kOhm) at one week, twice this value at 2 months (mean 2.32, range 1.11,3.75 kOhm) and was stable thereafter. Maximal abduction was achieved at a stimulation range of 0.65,7.2 mA. No electrical leakage was observed. Constant stimulation of the recurrent laryngeal nerve for 60 min led to full abduction without evidence of muscle fatigue. Conclusions: Functional electrical stimulation of the recurrent laryngeal nerve leading to full arytenoid abduction can be achieved. The minimal stimulation amplitude for maximal abduction angle is slightly higher than those for man and dogs. Clinical relevance: This treatment modality could eventually be applicable to horses with recurrent laryngeal neuropathy. [source]

Functional electrical stimulation in neurological disorders

EUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2008
O. K. Sujith
Functional electrical stimulation (FES) refers to electrical stimulation of muscles in order to improve the impaired motor function. This is achieved by activating skeletal muscles with constant frequency trains of stimulations. This method has been found useful in various neurological disorders like hemiplegia, foot drop and paraplegia including spinal cord injuries. The first half of this review focuses on the broad clinical applications of functional electrical stimulation, its mechanism of action and the complications of this mode of therapy. Advanced Parkinson's disease (PD) is characterized by marked slowing of gait and frequent freezing episodes. Medical and surgical treatments are often ineffective in managing freezing episodes. The second half of this review discusses briefly the gait abnormalities in PD and the available treatment options. The possible role of FES in improving gait in parkinsonism and the importance of future research in this direction are highlighted. [source]

Clinical Practice of Functional Electrical Stimulation: From "Yesterday" to "Today"

Immediate effect of percutaneous intramuscular stimulation during gait in children with cerebral palsy: a feasibility study

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 10 2005
Margo N Orlin PT PhD PCS
The feasibility of percutaneous intramuscular functional electrical stimulation (P-FES) in children with cerebral palsy (CP) for immediate improvement of ankle kinematics during gait has not previously been reported. Eight children with CP (six with diplegia, two with hemiplegia; mean age 9 years 1 month [SD 1y 4mo; range 7y 11mo to 11y 10mo]) had percutaneous intramuscular electrodes implanted into the gastrocnemius (GA) and tibialis anterior (TA) muscles of their involved limbs. Stimulation was provided during appropriate phases of the gait cycle in three conditions (GA only, TA only, and GA/TA). Immediately after a week of practice for each stimulation condition, a gait analysis was performed with and without stimulation. A significant improvement in peak dorsiflexion in swing for the more affected extremity and dorsiflexion at initial contact for the less affected extremity were found in the GA/TA condition. Clinically meaningful trends were evident for improvements in dorsiflexion kinematics for the more and less affected extremities in the TA only and GA/TA conditions. The results suggest that P-FES might immediately improve ankle kinematics in children with CP. [source]

Therapeutic effects of functional electrical stimulation of the upper limb of eight children with cerebral palsy

Considerations for pacing of the cricoarytenoid dorsalis muscle by neuroprosthesis in horses

Functional electrical stimulation in neurological disorders

Cortical and subcortical correlates of functional electrical stimulation of wrist extensor and flexor muscles revealed by fMRI

Gain scheduling control of functional electrical stimulation for assisted standing up and sitting down in paraplegia: a simulation study

INTERNATIONAL JOURNAL OF ADAPTIVE CONTROL AND SIGNAL PROCESSING, Issue 5 2005
Fabio Previdi
Abstract This paper reports on a simulation study that concerns the design of a non-linear controller for the standing up and the sitting down of a paraplegic patient by means of functional electrical stimulation. The simulations refer to a specific experimental device developed at the Fondazione Don Gnocchi (Italy). This is a seesaw, with the patient on one side and a weight on the other side. The patient is seated so that its posture can be fully known in real-time by continuously monitoring the knee joint angle. By delivering a suitable electrical stimulation to the quadriceps muscles groups, the patient can be raised and made to sit via smooth movements. Hitherto, the only feedback control law, which has been implemented in this area, is based on a PID controller and usually provides poor tracking performances. Hence, in this work, a non-linear gain scheduling controller has been designed and tested in a series of simulation experiments. The controller is tuned following a gain scheduling strategy: a set of local linear quadratic controllers is designed using a set of linear tangent models. A global non-linear gain scheduled controller is then obtained via interpolation. The gain- scheduled controller is implemented following an advanced strategy that guarantees that the so-called linearization property holds. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Identification of a class of non-linear parametrically varying models

INTERNATIONAL JOURNAL OF ADAPTIVE CONTROL AND SIGNAL PROCESSING, Issue 1 2003
F. Previdi
The aim of this paper is to propose a novel class of non-linear, possibly parameter-varying models suitable for system identification purposes. These models are given in the form of a linear fractional transformation (LFT) where the ,forward' part is represented by a conventional linear regression and the ,feedback' part is given by a non-linear dynamic map parameterized by a neural network (NN) which can take into account scheduling variables available for measurement. For this specific model structure a parameter estimation procedure has been set up, which turns out to be particularly efficient from the computational point of view. Also, it is possible to establish a connection between this model class and the well known class of local model networks (LMNs): this aspect is investigated in the paper. Finally, we have applied the proposed identification procedure to the problem of determining accurate non-linear models for knee joint dynamics in paraplegic patients, within the framework of a functional electrical stimulation (FES) rehabilitation engineering project. Copyright © 2002 John Wiley & Sons, Ltd. [source]

Myogenesis contributes to functional electrical stimulation (fes)-induced recovery of myofiber excitability and mass of human long-term denervated muscles in spinal cord injury (SCI)

JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM, Issue 2 2004
H Kern
Many months after SCI, when an irreversible injury involves lower motoneurons, severe atrophy of human muscle is complicated by fibrosis and fat substitution (denervated, degenerated muscle, DDM). We will describe the effects of long-term lower motoneuron denervation on human muscle and present the structural results of muscle trained using FES. Antibody for embryonic myosin demonstrates that sustained myogenesis occurs in human DDM. By electron microscopy we studied: a) the overall structure of fibers and myofibrils in long-term DDM, including the effects of FES, and b) the structure and localization of calcium release units, or triads, the structure deputed to activate muscle contraction during excitation-contraction coupling (ECC). The poor excitability of human long-term DDM fibers during the first stages of FES training could be explained in terms of spatial disorder of both the ECC and contractile apparati. The structural studies are extremely encouraging since they demonstrate that FES training is effective in reverting long-term DDM atrophy and in maintaining the trophic state of the recovered myofibers. [source]

Predicting the effect of muscle length on fatigue during electrical stimulation

MUSCLE AND NERVE, Issue 4 2009
M. Susan Marion PhD
Abstract Mathematical models have been developed to predict fatigue during functional electrical stimulation, but the predictive accuracy at different muscle lengths is unknown. The objectives of our study were to: (1) experimentally determine the relationship between knee extension angle (20°, 40°, 65°, and 90°) and fatigue of the quadriceps muscles, and (2) predict that relationship using a mathematical model. A computer-controlled stimulator sent trains of pulses to surface electrodes on the thighs of five subjects while forces were measured at the ankle. A two-component mathematical model was developed. One component accounted for force, and the other accounted for fatigue. The model was fit to the data, and parameters were identified at 90°. The fitted subject-averaged r2 value was 0.89. The model was used to predict fatigue at the remaining angles, and the subject-averaged r2 values were >0.75. Therefore, at least 75% of the variability in the measurements was explained by the model. The force model is explicitly dependent on angle, and the fatigue model is explicitly dependent on force; therefore, the dependence of fatigue on knee angle was implicit. Muscle Nerve, 2009 [source]

Development and Experimental Identification of a Biomechanical Model of the Trunk for Functional Electrical Stimulation Control in Paraplegia

NEUROMODULATION, Issue 4 2008
Ingenieur Michele Vanoncini
ABSTRACT Objectives., Theoretic modeling and experimental studies suggest that functional electrical stimulation (FES) can improve trunk balance in spinal cord injured subjects. This can have a positive impact on daily life, increasing the volume of bimanual workspace, improving sitting posture, and wheelchair propulsion. A closed loop controller for the stimulation is desirable, as it can potentially decrease muscle fatigue and offer better rejection to disturbances. This paper proposes a biomechanical model of the human trunk, and a procedure for its identification, to be used for the future development of FES controllers. The advantage over previous models resides in the simplicity of the solution proposed, which makes it possible to identify the model just before a stimulation session (taking into account the variability of the muscle response to the FES). Materials and Methods., The structure of the model is based on previous research on FES and muscle physiology. Some details could not be inferred from previous studies, and were determined from experimental data. Experiments with a paraplegic volunteer were conducted in order to measure the moments exerted by the trunk-passive tissues and artificially stimulated muscles. Data for model identification and validation also were collected. Results., Using the proposed structure and identification procedure, the model could adequately reproduce the moments exerted during the experiments. The study reveals that the stimulated trunk extensors can exert maximal moment when the trunk is in the upright position. In contrast, previous studies show that able-bodied subjects can exert maximal trunk extension when flexed forward. Conclusions., The proposed model and identification procedure are a successful first step toward the development of a model-based controller for trunk FES. The model also gives information on the trunk in unique conditions, normally not observable in able-bodied subjects (ie, subject only to extensor muscles contraction). [source]

The Effect of Using Variable Frequency Trains During Functional Electrical Stimulation Cycling

NEUROMODULATION, Issue 3 2008
Simona Ferrante PhD
ABSTRACT Objectives., This paper describes an experimental investigation of variable frequency stimulation patterns as a means of increasing torque production and, hence, performance in cycling induced by functional electrical stimulation. Materials and Methods., Experiments were conducted on six able-bodied subjects stimulating both quadriceps during isokinetic trials. Constant-frequency trains (CFT) with 50-msec interpulse intervals and four catchlike-inducing trains (CIT) were tested. The CITs had an initial, brief, high-frequency burst of two pulses at the onset of or within a subtetanic low-frequency stimulation train. Each stimulation train consisted of the same number of pulses. The active torques produced by each train were compared. Parametric main effect ANOVA tests were performed on the active torque-time integral (TTI), on the active torque peaks and on the time needed to reach those peaks (T2P). Results., The electrical stimulation of the quadriceps produced active torques with mean peak values in the range of 1.6,3.5 Nm and a standard error below 0.2 Nm. CITs produced a significant increase of TTI and torque peaks compared with CFTs in all the experimental conditions. In particular, during the postfatigue trials, the CITs with the doublet placed in the middle of the train produced TTIs and torque peaks about 61% and 28% larger than the CFT pattern, respectively. In addition, the CITs showed the lowest reduction of the performance between prefatigue and postfatigue conditions. Conclusions., The use of CITs improves the functional electrical stimulation cycling performance compared with CFT stimulation. This application might have a relevant clinical importance for individuals with stroke where the residual sensation is still present and thus the maximization of the performance without an excessive increase of the stimulation intensity is advisable. Therefore, exercise intensity can be increased yielding a better muscle strength and endurance that may be beneficially for later gait training in individuals with stroke. [source]

Interaction of Artificial and Physiological Activation of the Gastrocnemius During Gait

NEUROMODULATION, Issue 2 2008
Colleen C. Monaghan BSc
ABSTRACT Objectives., The purpose of this research was to understand the effects of surface functional electrical stimulation (FES) of the tibial nerve on the activation of the gastrocnemius medialis of the stimulated side. Methods., FES was carried out on six healthy subjects, initiated at three different times during gait: early, mid, and late stance. Each stimulation burst consisted of 15 pulses, applied for 300 msec, at 50 Hz stimulation frequency. Mixed model statistical analysis was carried out on the median onset and offset times of the gastrocnemius medialis and the root mean square of the interpulse interval responses. Results., Results indicate that the electromyography response to FES is dependent on the time of application. The most prominent effects found in the intervals between the stimulation pulses (interpulse intervals) were found when stimulation was applied early in the stance phase. This study revealed that the only statistically significant effect on burst timing was a delay in offset timing due to mid-timed stimulation. Conclusions., We conclude that additional activation may have been compensated, at least in part, by blocking of the physiological activation during the stimulation burst. [source]

Feasibility of Gait Event Detection Using Intramuscular Electromyography in the Child with Cerebral Palsy

NEUROMODULATION, Issue 3 2004
Richard T. Lauer PhD
Abstract The objective of this study was to develop and test the feasibility of a model that employs electromyographic (EMG) signals to predict the occurrence of gait events in the child with cerebral palsy (CP). This model could be the basis of a future functional electrical stimulation (FES) control system to assist gait. Two children were implanted with bifilar intramuscular electrodes into the quadriceps muscle bilaterally. Muscle activity and gait parameters were recorded, and a fuzzy inference system was used to correlate EMG to five distinct gait events. For nine of the 10 gait events evaluated, the model predicted gait events to within 82 ms on average, as referenced to the VICON motion analysis system. For eight of the 10 events, prediction errors were 0.3% or less. Results indicate that EMG from the proximal musculature could be used to predict the occurrence of gait events in these two children with CP. [source]

Wearable Data Collection System for Online Gait Stability Analysis

NEUROMODULATION, Issue 3 2004
Tomaz Karcnik DSc
Abstract We had shown in our previous research that the stability assessment and control are essential for generation of faster and more energy efficient functional electrical stimulation (FES) and/or crutch-assisted gait. The objective of our recent research work has been to design a wearable and portable system for gait stability analysis with online capabilities that is also applicable to crutch-assisted gait modes. The developed wearable stability assessment system for as yet only biped gait consists of foot switches and goniometers attached to the leg joints. The instantaneous static and dynamic stability is, within the wearable system, assessed from the trajectory of the estimated body center of gravity (COGHAT) and the supporting area shape/size as derived from step length and foot-floor contact state. We used motion analysis system data as reference for testing the wearable system accuracy. The wearable system was tested on five healthy subjects and one above-knee amputee. It proved to be reasonably accurate if compared to the classical, motion analysis system based method. However, additional work is required to port the system to the FES assisted and/or crutch assisted gait. [source]

ORIGINAL RESEARCH,WOMEN'S SEXUAL HEALTH: Biofeedback, Electrical Stimulation, Pelvic Floor Muscle Exercises, and Vaginal Cones: A Combined Rehabilitative Approach for Sexual Dysfunction Associated with Urinary Incontinence

THE JOURNAL OF SEXUAL MEDICINE, Issue 6 2009
Massimo Rivalta MD
ABSTRACT Introduction., Urinary incontinence (UI) is often associated with sexual dysfunction. We present our preliminary experience with a combined rehabilitative approach consisting of biofeedback, functional electrical stimulation, pelvic floor muscle exercises, and vaginal cones. Aim., The potential impact of such practice on UI and sexual function was analyzed in our case series and discussed. Main Outcome Measures and Methods., We evaluated three women affected by UI and sexual dysfunction. The patients underwent combined pelvic floor rehabilitation (PFR), kept voiding diaries, and filled out the Female Sexual Function Index (FSFI questionnaire) before and after the completion of PFR. We evaluated each domain score, including desire, arousal, lubrication, orgasm, satisfaction, and pain. Results., After the combined rehabilitation program, none of them had UI requiring pad use or referred urine leakage during sexual activity, including intercourse. Before PFR, FSFI score ranged from 16 to 21; after treatment, the FSFI score ranged from 22.1 to 29.3. There was an improvement in patients regarding desire, arousal, lubrication, orgasm, satisfaction, and pain. Conclusions., A complete rehabilitation can provide a beneficial effect on sexual function. A larger trial, on a more extended female population, is currently in progress, in order to confirm our findings. The effectiveness of a complete PFR scheme, together with the lack of side effects, makes it a suitable approach to sexual dysfunction that is associated with UI. Rivalta M, Sighinolfi MC, De Stefani S, Micali S, Mofferdin A, Grande M, and Bianchi G. Biofeedback, electrical stimulation, pelvic floor muscle exercises, and vaginal cones: A combined rehabilitative approach for sexual dysfunction associated with urinary incontinence. J Sex Med 2009;6:1674,1677. [source]