Protocol Guide Set 1

SET 1 PROTOCOL GUIDE

MARKS SOFTWARE TOOLS FOR PELVIC MUSCLE DYSFUNCTION

The protocols on this CD are arranged in three broad categories:

Incontinence Protocols
Dyssynergia/Constipation Protocols
Pain Protocols

Continence and pain protocols contain long and short versions. Short (s) protocols have 30 second pre/post baselines and endurance segments. Long (l) protocols have 60 second pre/post baselines and endurance segments. The quick contractions in the Continence Protocol Series have short rest periods between quick contractions (quick flicks). The Pain Protocol Series have 10 second rest periods between the quick flicks. An assortment of screens and music are used for variety and fun. Both the therapist and patient can choose their favorites.
Additionally, there is an MEP Sensor Protocol Series which uses the short incontinence, short pain, and dyssynergia protocol formats but which screens with appropriate labels for the MEP sensor (see details below).

**Continence Protocol Series**
Use for patients presenting with:	Urge, stress, and mixed urinary incontinence Fecal incontinence Post-prostatectomy incontinence
#2Ch (s) CONTINENCE 30 second pre-baseline (5) quick contractions with short rest periods (5) ten second contract and relax segments 30 second post-baseline 30 second endurance 2 channels EMG pelvic/abdominal Music: dream Screen: Eval 2 Ch Black*	#2Ch (l) CONTINENCE 60 second pre-baseline (5) quick contractions with short rest periods (5) ten second contract and relax segments 60 second post-baseline 60 second endurance 2 channels EMG pelvic/abdominal Music: dream Screen: Eval 2Ch Black
#1Ch (s) CONTINENCE 30 second pre-baseline (5) quick contractions with short rest periods (5) ten second contract and relax segments 30 second post-baseline 30 second endurance 1 channel EMG pelvic Music: dream Screen: Eval/TexOff/1Ch Blue	#1Ch (l) CONTINENCE 60 second pre-baseline (5) quick contractions with short rest periods (5) ten second contract and relax segments 60 second post-baseline 60 second endurance 1 channel EMG pelvic Music: ocarina Screen: Eval/TexOff/ 1Ch Green

The Dyssynergia/Constipation Protocols are used to assess an aspect of the synergistic motor activity required for effective elimination. They also assess the ability to relax and stretch the pelvic floor muscles. Patients are asked to "push-out" their pelvic floor muscles as if they were attempting to have a bowel movement. Dyssynergia protocols are identical except for graphics, music, and number of EMG channels.

**Dyssynergia/Constipation Protocol Series**
Use this protocol in conjunction with other protocols and with patients presenting with:	Chronic constipation Urinary frequency and hesitancy Chronic pelvic pain syndromes Vulvodynia
#1Ch Dyssynergia 30 seconds pre-baseline (5) rounds: relax (6 sec.), contract (6 sec.), push-out (10 sec.) 30 seconds post-baseline 1 channel EMG pelvic Music: fuselise Screen: Eval/TexOff/1Ch Blue	#2Ch Dyssynergia 30 seconds pre-baseline (5) rounds: relax (6 sec.), contract (6 sec.), push-out (10 sec.) 30 seconds post-baseline 2 channels EMG pelvic/accessory labels Music: ocarina Screen: Eval/TexOff/2Ch

**Pain Protocol Series**
Use the Pain protocol for patients presenting with:	Pelvic floor tension syndrome Vulvodynia/vulvar vestibulitis Chronic constipation Urinary frequency and hesitancy
# 2Ch (s) PAIN 30 second pre-baseline (5) quick contractions with ten second rest periods (5) ten second contract and relax segments 30 second post baseline 2 channel EMG pelvic/abdominal labels Music: dream Screen: Eval/TexOff 2Ch Grey	# 2Ch (l) PAIN 60 second pre-baseline (5) quick contractions with ten second rest periods (5) ten second contract and relax segments 60 second post baseline 60 second endurance 2 channel EMG pelvic/abdominal labels Music: fuselise Screen: Eval/TexOff/2Ch Grey
# 1Ch (s) PAIN 30 second pre-baseline (5) quick contractions with ten second rest periods (5) ten second contract and relax segments 30 second post baseline 1 channel EMG pelvic label Music: Debussy Screen: Eval/TexOff/1Ch Blue	# 1Ch (l) PAIN 60 second pre-baseline (5) quick contractions with ten second rest periods (5) ten second contract and relax segments 60 second post baseline 60 second endurance 1 channel EMG pelvic label Music: Debussy Screen: Eval/TexOff/1Ch Green

The MEP Protocols are to be used with the MEP rectal sensor designed by Jeanette Tries. These sensors can be obtained from SRS Self Regulation Systems, 800-345-5642 and Bio-Medical Instruments, Inc., 800- 521-4640. The new MEP sensor has two channels of EMG (proximal and distal) on a single, small rectal probe. When you order the sensors ask for a free adapter.

**MEP Protocol Series**
## MEP (s) CONTINENCE 30 second pre-baseline (5) quick contractions (5) ten second contract and relax segments 30 second post baseline Proximal/Distal Rectal EMG, Abdominal EMG Music: dream Screen: Eval MEP with Abs	## MEP (s) PAIN 30 second pre-baseline (5) quick contractions with ten second rest periods (5) ten second contract and relax segments 30second post baseline 30 second endurance Proximal/Distal Rectal EMG, Abdominal EMG Music: dream Screen: Eval MEP with Abs
##MEP DYS ## MEP DYS no music 30 second pre-baseline (5) rounds: relax (6 sec.), contract (6 sec.), relax (6 sec.) push-out (10 sec.) 30 second post-baseline Proximal/Distal EMG Music: ocarina Screen: Eval MEP Sensor	## MEP DYS w ABS 30 second pre-baseline (5) rounds: relax (6 sec.), contract (6 sec.), relax (6 sec), push-out (10 sec) 30 second post-baseline Proximal/Distal EMG, Abdominal EMG Music: ocarina Screen: Eval MEP with Abs

In addition to the above protocols there are three 2 Channel short protocols without music during the pre and post baseline periods.

#2Ch DYS no music
#2Ch (s) CONT no music
#2Ch (s) PAIN no music

MEPAdapter Information:
The adapter is a box with snaps on two sides where you connect your EMG leads. Look at the box from the side where you plug in the MEP sensor and the ground. Position the box so the ground is on the left. The top set of snaps should receive the lead coming from your C channel on the Procomp. This tracing will come from the proximal sensor. The bottom set of snaps should be connected to your D channel on the Procomp which gives a tracing from the distal sensor on the probe.

Return to Marks Software Home