Equipment - EMG (Neurotrac) | Innerstrength Healthcare

Electromyographic biofeedback (EMG‐BFB) does not do anything to your muscles.

It listens to or detects the electrical activity of your muscle and feeds this back in vision and sound.

It uses electrodes placed next to your muscles to generate a feedback signal (in vision or sound) in response to muscle activation.

It is used to help you learn to control your pelvic floor or other muscles.

The goal might be to increase your ability to contract or relax your pelvic floor.

Use the machine daily or as instructed by your physiotherapist.

If you run into some trouble with the machine go through the troubleshooting steps below before calling Innerstrength Physiotherapy for help.

Where do I get EMG?

At Innerstrength we hire and sell all the equipment you might need to use EMG at home.

Set up your EMG

Attach single end of your lead to centre hole of the Biofeedback unit.

Lead Neurotrac Top of Neurotrac

Plug the earth lead into the small hole on the Biofeedback unit

Earth lead Top of Neurotrac

Attach the small adhesive square to the end of the Earth Lead

Adhesive square

Earth Lead attaches to a nearby prominent bone
Peel off plastic backing from adhesive square and ensure the gel pad is moist. If it is not, place a drop of water on it. Put the electrode backing in the box for later use.
Stick to your hip bone as you were shown.

Vaginal or Anal Sensor preparation

Wash hands before handling sensor.

Connect the black and red plugs into the end of sensor electrode.

Apply a small amount of lubricant gel to the sensor, spreading it evenly over the surface.

Insert the sensor Lying comfortably on your side or stand with your underpants down insert the sensor gently into vaginal or anal canal (as shown by your physiotherapist).

If you have had a history of pain in this area do a few minutes of your relaxation training before attempting to insert.

Vaginal Sensor(Large size) Anal Sensor

You may now need to pull up your underpants to keep the electrode from slipping out.

You may sit on the toilet seat if instructed by your physiotherapist.

In Clinic Training

In our clinic we show you how to set it up.

For those that are pretty shy we can give the electrodes to you to put in place and then do a quick visual placement check once they are in place.

We can then continue the training with your underpants on.

Skin Preparation

There are three sticky electrodes used with EMG.

Please note the electrodes are stickiest the first time you use them.

If there is hair over the target muscles it may be helpful to shave the area before to avoid the pain of electrode removal.

After a few uses they lose some of their adhesiveness and so shaving is not longer required.

Always make sure the skin has recently been washed and is free of moisturiser or ointment.

Care of electrodes

The electrodes need careful handling.

NEVER pull the electrodes off your skin by pulling on the lead! They should be peeled off their backing (or the skin) by gently pulling on the corner of the electrode itself.

They should be applied to clean (washed with soap and water,) dry skin – this is particularly important in warm weather.

After use they should be placed immediately back onto their plastic backing, press out all the air bubbles between the electrode and backing.

Once a week add 2-3 drips of water on the back of each electrode. No more. Store them flat in their sealed bag to prevent drying out and deterioration.

If electrodes are properly cared for they should last for many uses.

Please care for leads by avoiding twisting, bending and wrapping them around the machine as they are fragile.

When to throw out an electrode

DO NOT use an electrode if it does not stick all over the skin. If a corner starts to peel off when you put it on the skin, throw it away and use a new electrode.

If you or your child experiences a prickling sensation that wasn’t there before, it may be because the electrode is not adhering properly to the skin.

If the skin becomes irritated or there are any problems with your machine, stop using it and contact your physiotherapist.

Electrode Placement

Two are attached to the double lead and are placed close to the target muscles.

They need to be at least 1 finger apart.

The third electrode attached to the single lead is placed on the skin over a prominent bone such as your hip.

These could be around your anal muscles or more forward on your perineal body.

Preprogrammed Exercise Session

Press the ON/OFF button once.

You will notice that a beeping sound or a green or orange light might be on.

Press START.

You will notice that the EMG will start a preprogrammed regime with a timer to guide you through a work (WRK) and rest (RST) cycle.

A small triangle will appear next to either WRK or RST and you can follow its lead.

Tighten your pelvic floor or anal muscles around the electrode whilst the triangle is on WRK and try to keep the light green.

Relax your pelvic floor and or anal and abdominal muscles immediately around the electrode whilst the triangle is on RST.

Stay relaxed and engage in quiet diaphragm breathing (with a rise and fall of your tummy/abdomen) whilst the RST triangle is displayed.

The light should go down to the orange zone or even off if possible.

Repeat until the machine finishes.

Rest and do as many sets as you can.

Unprogrammed Exercise Session

In the unprogrammed session your physiotherapist may give you a contraction time, a relaxation time and a number of repetitions to do.

In general if you are working on training UP or strengthening your pelvic floor your rest time is either same or double the time of your contraction.

In general if you are working on training DOWN or learning to relax your pelvic floor your rest time is at least triple the time of your contraction.

Press the ON/OFF button once.

You will notice that a beeping sound or a green or orange light might be on.

Tighten your pelvic floor or anal muscles around the electrode and try to keep the light green for as many seconds as you can.

Then relax your pelvic floor and or anal and abdominal muscles around the electrode for three times as many seconds.

Stay relaxed and engage in quiet diaphragm breathing (with a rise and fall of your tummy/abdomen).

The light should go down to the orange zone or even off if possible.

Repeat until your muscles become inefficient and fatigue.

Rest for a minute and do as many sets as you can.

Clean and store Electrode

At the end of the session, press the ON/OFF button, remove the sensor and wipe secretions off sensor with tissue and discard tissue.

Wash sensor thoroughly in flowing warm, soapy water.

Rinse all soap residue and dry sensor with clean cloth and replace in a clean dry cloth.

Peel off the adhesive electrode from your skin via the corner (not the lead) and replace on the plastic backing and seal in the snap lock bag.

Troubleshooting

If you are having problems with EMG call the office 52297963 after trying the following.

Remove the sensor, put a little more lubricant and reinsert.

Turn off electrical appliances that are nearby.

Try a different lubricant.

Remove and replace the battery.

Inspect the leads for kinks.

Remove and return all connections to the machine i.e. the adhesive square and the insertable electrode.

Ensure the adhesive square is well attached to your skin. You may need a replacement if it is not sticking well.

Volume Control

you can control the volume in the following way

Press Set.
Then press the + trianagle to turn up and the - traingle to turn down.
Press ESC to return to the live screen.

Advance your progress

For those of you that are improving really well during you hire period you may like to alter the machine to challenge yourself further.

To do this you can alter the THRS triangular buttons to change the number in the top right hand corner.

THRS is the threshold that the lights and sound activate or deactivate.

To make this number higher press the top trinagle. i.e Press +

To make this number lower press the bottom triangle. i.e Press -

If you are seeking a challenge to better strengthem your pelvic floor increase that number. i.e Press +

If you are seeking a challenge to better relax your pelvic floor lower that number. i.e Press -

Threshold

Adjust the threshold by pressing the Plus or MInus button on the faceof the machine. This adjusts the sensitivity of the machine. The threshold number is indicated at the top of the LCD screen. and remains the same between uses.
Please adjust this to a point where, when you are resting the light is as close to the middle of the orange light area as you can get, when you contract ideally when you contract your muscles, you can easily move the lights into the green zone.
It is likely this will need adjusting as you improve at pelvic floor control.