Introducing Elvie Trainer

Pelvic floor muscle training is known to be effective in treating, improving and preventing cases of stress, urgency or mixed urinary incontinence, pelvic organ prolapse and lower bowel dysfunction. However, 30% of women cannot perform a healthy pelvic floor contraction with only written or verbal instruction (Bø, 2004). Comparing pelvic floor muscle training with biofeedback to pelvic floor muscle training alone, women using biofeedback see better improvement and a better long-term effect on motivation (Glavind, 1996). Over one year, adding a biofeedback device to pelvic floor muscle training increases success rates by 10% (Imamura, 2010).

Elvie Trainer is an over-the-counter pelvic floor muscle training guide and tracker for single-patient use, enabling patients to benefit from clinical biofeedback at home. The user places Elvie Trainer inside her vagina and it connects to an app, guiding her through a five-minute workout. The device makes pelvic floor muscle training fun and easy for patients, for between clinic visits and thereafter. The workouts were created with the support of women’s health physical therapist, Dr Kay Crotty (Physiolink), and urogynaecologist, Dr Rufus Cartwright (Oxford University Hospitals Trust). The workouts incorporate clinical recommendations on the need for targeting fast-twitch and slow-twitch muscle fibres.

The device uses a unique and patented combination of force and motion sensors to detect if the user is performing a Valsalva maneuver, rather than the correct cranioventral lift, then reports this to the user via the app. The user is encouraged to seek the help of a women’s health physical therapist, should she be notified repeatedly that she is performing the Valsalva maneuver and is unable to correct the movement. Elvie Trainer is the only at-home biofeedback device that can detect Valsalva maneuver.

Women’s health physical therapist, Sinead McCarthy, conducted a study to validate Elvie Trainer’s ability to detect Valsalva maneuver. She compared data from Elvie Trainer and transperineal ultrasound in healthy subjects performing the correct cranioventral lift and Valsalva maneuver and found 96% agreement between the data for proximal urethral inclination and 94.67% agreement between the data for Valsalva maneuver (McCarthy, 2017).

The positive impact of Elvie Trainer in enhancing compliance and improving outcomes with pelvic floor muscle training is also well evidenced. Elvie Trainer users were invited to participate in a survey based on patient reported outcome measures, regarding motivation to purchase an Elvie Trainer and their experiences. Users who answered ‘improve bladder control’ or ‘prevent bladder problems in the future’ to the question regarding main motivation to purchase were invited to answer questions from ICIQ-UI short form questionnaire on urinary incontinence symptoms and experience and the PGI-I question on improvement of condition with Elvie Trainer. Results demonstrated that 80% of women who purchase an Elvie Trainer to treat a bladder problem see improvement; 98% do so in less than six weeks. This work was co-authored by Dr Jack Coggins (Elvie data scientist), Dr Rufus Cartwright (Oxford University Hospitals Trust, urogynaecologist) and myself and was presented at the International Continence Society annual conference (Coggins, 2017).

Elvie Trainer is a great complementary tool to the work of health professionals – now available to buy through CMT!

References:

Bø, K. (2004). Urinary incontinence, pelvic floor dysfunction, exercise and sport. SportsMedicine, 34(7), 451-464.

Coggins, J. et al. (2017) Self-reported changes in pelvic floor training frequency and incontinence symptoms with the intravaginal Elvie device. International Continence Society. Accessed 20.02.18. Available here: https://www.ics.org/Abstracts/Publish/349/000213.pdf

Glavind, K., Nøhr, S. B., & Walter, S. (1996). Biofeedback and physiotherapy versus physiotherapy alone in the treatment of genuine stress urinary incontinence. International Urogynecology Journal, 7(6), 339-343. http://doi.org/10.1007/BF01901111

Imamura et al. (2010) Systematic review and economic modelling of the effectiveness and cost-effectiveness of non-surgical treatments for women with stress urinary incontinence. Health Technology Assessment 2010; Vol. 14: No. 40

McCarthy, S. (2017) Does Elvie compare with real-time transperineal ultrasound measurement of urethral movement direction? Journal of Pelvic, Obstetric and Gynaecological Physiothe