***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objective : To determine whether Whole Body Vibration Training ( WBVT ) is effective at improving pelvic floor muscles strength in women with Stress Urinary Incontinence ( SUI ) . Material s and methods : The study was design ed as a r and omized clinical trial . 43 women with SUI were r and omly assigned in two groups ; WBVT and Pelvic Floor Muscle Training ( PFMT ) and received interventions for four weeks . Pelvic floor muscle ( PFM ) strength , quality of life and incontinence intensity were evaluated . All measurements were conducted pre and post intervention and also after 3 months in all participants . The ANOVA and the independent sample t test were applied respectively to determine the differences in each group and between the groups . Results : This study showed the WBVT protocol in this study was effective in pelvic floor muscles strength similar to PFMT , and also in reducing the severity of incontinence and increasing I-QOL question naire score . We found significant differences in each group pre and post intervention ( p = 0.0001 ) ; but no significant difference in comparison of two groups ' outcomes . Also after three-month follow up , there was no significant difference between groups . Conclusion : The findings of this study showed the beneficial effects of WBVT in improving pelvic floor muscles strength and quality of life in patients with urinary incontinence in four-week treatment period and after three months follow up PURPOSE to compare the effects of functional electrostimulation of the pelvic floor and therapy with cones in women with stress urinary incontinence ( SUI ) . METHODS r and omized clinical study for which 45 patients with SUI were selected . The effects of functional electrostimulation of the pelvic floor were evaluated in the SUI treatment of 24 women , with the use of clinical data ( micturition diary , pad test and a question naire about quality of life - I-QoL ) . The patients were su bmi tted to two 20 ' weekly sessions for four consecutive months , under the supervision of a physiotherapist . The electrode used had 10 cm length and 3.5 cm width with a double metallic ring and a cylindrical shape , positioned in the medium third of the vagina . The electric parameters used were : intensity varying from 10 to 100 mA and 50 Hz of fixed frequency , with pulse duration of 1 ms . Also , we evaluated 21 patients who were su bmi tted to vaginal cone treatment . The cone therapy was done with two 45 minute sessions per week . The cones ' weight varied from 20 to 100 gr . RESULTS there was no difference between the outcomes of electrostimulation of the pelvic floor and the vaginal cones for the treatment of SUI ( p>0.05 ) . After four months , there was a significant improvement in the I-QoL index of the patients treated both with electrostimulation ( 40.3 versus 82.9 ) or with the cones ( 47.7 versus 84.1 ) . There was a significant decrease in pad weight in both groups , measured before and after the treatment ( 28.5 and 32 g versus 2.0 and 3.0 g for the electrostimulation and cone group , respectively ) . Finally , there was a significant decrease in the number of urinary leakage evaluated by the micturition diary in both groups ( p<0.0001 ) . CONCLUSIONS both electrostimulation and vaginal cones were effective in the treatment of women with SUI OBJECTIVE To evaluate the effectiveness of pelvic floor muscle exercises ( PFMEs ) performed with the new biofeedback Vibrance Kegel Device ( VKD ) , compared to PFMEs alone , in treating  stress urinary incontinence ( SUI ) . MATERIAL S AND METHODS This was a pilot prospect i ve , r and omized trial of women aged ≥18 years with SUI symptoms who underwent PFMEs at University Malaya Medical Centre from October 2011 to October 2013 . The patients were r and omly divided into two groups : control ( PFMEs alone ) and VKD ( PFMEs with VKD biofeedback ) . The patients underwent 16 weeks of pelvic floor training , during which they were assessed using Australian pelvic floor question naires and modified Oxford scales for pelvic floor muscle strength at week 0 , 4 , and 16 . RESULTS Forty patients were recruited ( control 19 , VKD 21 ) . Three patients in the control group dropped out during week 16 training , whereas the VKD group had no dropouts . The VKD group reported significantly earlier improvement in SUI scores , as assessed by the Australian pelvic floor question naires ( P = .035 ) at week 4 . However , there was no significant difference between the groups ' SUI scores at week 16 . Pelvic floor muscle strength was significantly better in the VKD group at week 4 ( P = .025 ) and week 16 ( P = 0.001 ) . The subjective cure rate was similar in both groups at week 16 ( 62.5 % for control and 61.9 % for VKD ) ( P = 0.742 ) . CONCLUSION Using the VKD result ed in significant early improvement in SUI scores , and pelvic muscle strength had improved significantly by the end of the study . The VKD proved useful as an adjunct for pelvic floor training OBJECTIVE To evaluate the effects of surface electrical stimulation ( SES ) and to compare them with the effects of the intravaginal electrical stimulation ( IVES ) in women with stress urinary incontinence ( SUI ) . STUDY DESIGN This r and omized controlled study included 48 women aged over 50 years , who complained of SUI evaluated according to two structured questions of King 's Health Question naire ( KHQ ) and who had not previously undergone physical therapy for SUI . The calculation of the sample size estimated a sample of 45 volunteers with a significance level of 5 % and statistical power of 90 % . The women were r and omized to : Surface Electrical Stimulation Group ( SESG ) ( n=15 ) , Intravaginal Electrical Stimulation Group ( IVESG ) ( n=15 ) and Control Group ( CG ) ( n=15 ) . Subjects in the intervention groups were treated with the same parameters of electrical stimulation for 12 sessions . The SESG had four silicone electrodes fixed in the suprapubic and ischial tuberosity regions . The IVES group used an intravaginal electrode . The CG did not receive any treatment during the corresponding time . They were evaluated before and after treatment by a physical therapist who was blind to group allocation . The primary outcomes were urinary leakage , pressure and strength of pelvic floor muscle ( PFM ) contraction . The secondary outcome was quality of life ( QOL ) evaluated by KHQ . Forty-five women completed the study and were included in the analysis . Statistical analysis was performed using the Wilcoxon test for intragroup analysis and Kruskal-Wallis and Mann-Whitney tests for intergroup analysis ( p<0.05 ) . RESULTS There was significant improvement in urinary loss and pressure of contraction in the SESG and IVESG . PFM strength increased only in the IVESG . Intergroup analysis found differences after the treatment in : urinary leakage between the SESG and CG ( p<0.001 ) and the IVESG and CG ( p<0.001 ) . Regarding QOL , there was significant reduction in the incontinence impact , limitations of daily activities , physical limitation , emotion , sleep and disposition and severity domains in the SESG ( all p<0.02 ) and IVESG ( all p<0.04 ) after the treatments . CONCLUSION SES and IVES are important treatments to improve the SUI . Both improved the QOL , urinary leakage , and strength and pressure of PFM contraction OBJECTIVE The aim of this study was to determine if two different whole body vibration , sinusoidal vibration ( SV ) and stochastic resonance vibration ( SRV ) , using various intensities lead to a reactive activation of pelvic floor muscles . STUDY DESIGN We compared the pelvic floor muscle response of a healthy control group with that of a post partum group with weakened pelvic floor contraction . Activation effects of stochastic resonance vibration and sinusoidal vibration with six increasing vibration intensities were investigated using pelvic floor EMG and compared to activity during rest and maximum voluntary contraction . RESULTS Both whole body vibration systems were able to activate pelvic floor muscles significantly depending on vibration intensity . Generally , the SRV achieved a significantly higher activation than maximum voluntary contraction , especially in women post partum and using a frequency of 6 - 12 Hz . CONCLUSION SRV , compared to SV , leads to higher pelvic floor muscle activation in subjects with weakened pelvic floor muscles and achieves higher pelvic floor activation than maximum voluntary contraction alone . Neurourol . Urodynam . 28:405 - 410 , 2009 . ( c ) 2009 Wiley-Liss , Background More and more frequently stress urinary incontinence affects young healthy women . Hence , early implementation of effective preventive strategies in nulliparous continent women is essential , including pelvic floor muscle training . An initial evaluation based on the bioelectrical activity of the pelvic floor muscles ( PFM ) during whole-body vibration ( WBV ) would help to devise the best individualized training for prevention of stress urinary incontinence in woman . We hypothesized that synchronous WBV enhances bioelectrical activity of the PFM which depends on vibration frequency and peak-to-peak vibration displacement . Methods The sample consisted of 36 nulliparous continent women r and omly allocated to three comparative groups . Group I and II subjects participated in synchronous whole-body vibrations on a vibration platform ; the frequency and peak-to-peak displacement of vibration were set individually for each group . Control participants performed exercises similar to those used in the study groups but without the concurrent application of vibrations .  Pelvic floor surface electromyography ( sEMG ) activity  was recorded using a vaginal probe during three experimental trials limited to 30s , 60s and 90s . The mean amplitude and variability of the signal were normalized to the Maximal Voluntary Contraction – MVC . Results Friedman ’s two-way ANOVA revealed a statistically significant difference in the mean normalized amplitudes ( % MVC ) of the sEMG signal from the PFM during 60s- and 90s-trials between the group exposed to high-intensity WBV and control participants ( p < 0.05 ) . Longer trial duration was associated with a statistically significant decrease in the variability of sEMG signal amplitude in the study and control groups ( p < 0.05 ) . Conclusions Synchronous high-intensity WBV ( 40 Hz , 4 mm ) of long duration ( 60s , 90s ) significantly enhances the activation of the PFM in young continent women . Prolonged maintenance of a static position significantly decreases the variability of sEMG signal amplitude independent of whole-body vibrations . Single whole-body vibrations in nulliparous continent women does not cause pelvic floor muscle fatigue . Trial registration The trial was registered in the Australian and New Zeal and Clinical Trials Registry ( no. ACTRN12615000966594 ) ; registration date : 15/09/2015 BACKGROUND Neuromuscular electrical stimulation ( NMES ) is widely treatment for stress urinary incontinence ( SUI ) but there is no consensus in literature regarding the most effective treatment parameters . OBJECTIVE To compare two NMESintra-vaginal protocol s for the treatment of SUI in women . METHODS The study included 20 volunteers with an average age of 55.55±6.51 years and with the clinical diagnosis of SUI . Volunteers were r and omly divided into two groups : group 1 ( G1 ) received NMES with medium-frequency current and group 2 ( G2 ) received NMES with low-frequency current .  Functional assessment s of pelvic floor muscles ( PFM ) were performed by perineometry . The severity of signs and symptoms were objective ly evaluated using the 1 hour pad test and subjectively evaluated using a visual analog scale that measured the discomfort caused by the SUI . Shapiro-Wilk test was used to analyze data normality , and the Friedman test was used to analyze nonparametric data . For analysis of symptoms related to SUI the Fisher exact test and the Mann-Whitney test were used . Significance level of 5 % was set for all data analysis . RESULTS No significant differences ( p>0.05 ) were found between groups for any of the variable assessed . The within group analysis of initial and final evaluations ( after NMES ) demonstrated significant differences ( p<0.05 ) in amount of urine lost , the discomfort caused by urinary incontinence and perineal pressure for both treatment groups . CONCLUSION The two NMES protocol s applied were equally effective in the treatment of SUI OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.5 
    Output:
    
In spite of the heterogeneity of the protocol s , all the studies had the goal of assessing the effects of vibration on the PFM , and the stimulation was found to be effective in reducing urinary leakage , improving muscle strength and consequently the patients ’ quality of life .