Emsella Chair Versus Sham for the Treatment of Chronic Pelvic Pain

Corewell Health East11 enrolled

Overview

The purpose of this clinical trial is to compare the Emsella Chair therapy to Sham and to determine whether electromagnetic technology is effective in the treatment of chronic pelvic pain. Currently there are no other studies utilizing the Emsella Chair for the treatment of chronic pelvic pain. Eligible subjects will receive 2 treatments per week for a total of 4 weeks.

Chronic pelvic pain (CPP) is a common and often debilitating in both men and women. It occurs below the umbilicus and is severe enough to cause functional impairment or require treatment. The health care burden of CPP is substantial. First line treatments involve a multidisciplinary approach and include general relaxation and stress management, patient education, self-care and behavioral modification, and pain management. Second-line agents include physical therapy (avoiding kegel exercises), and oral and intravesical agents. More invasive options including neuromodulation. The Emsella chair is currently approved as a treatment for stress urinary incontinence. Chronic pelvic pain patients may benefit from treatment. The Emsella chair generates electromagnetic stimulation which is able to penetrate deep into the pelvic floor muscles inducing stimulation and providing rehabilitation for weak pelvic floor muscles. The Emsella chair is a novel high-intensity focused electromagnetic (HIFEM) technology for the treatment of stress urinary incontinence (SUI), in addition to other pelvic floor related disorders. HIFEM technology induces deep pelvic floor muscle contractions designed to deliver the equivalent of 11,200 Kegel exercises over 28 minutes.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Pelvic Pain

Interventions

BTL Emsella chairDEVICE

Subjects will sit on the device. The Research Nurse Coordinator (RNC) will turn the device on and increase the setting gradually until the patient reaches their sensory threshold. This is the maximum sensation the patient can tolerate. The treatment threshold should be increased with every treatment until the subject reaches 100%.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 80 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Able to read, understand, and provide written, dated, informed consent prior to screening, and be likely to comply with study protocol, including independently complete study questionnaires and communicate with study personnel about adverse events (AEs) and other clinically important information. 2. Females and males, 18 to 80 years of age, at screening 3. Self-reported CPP defined as pelvic pain that is non-cyclical and of at least 6 months duration and refractory to other treatments 4. Subject agrees not to start any new treatment for CPP (medication or otherwise) during the treatment and follow-up periods. 5. Subject agrees to maintain a stable dose all current medications throughout the treatment and follow-up period For Females Only: 6. If of child-bearing age and female, agree to practice approved birth-control methods (oral contraceptives, condom barrier, injection, diaphragm or cervical cap, vaginal contraceptive ring, Intrauterine device (IUD), implantable contraceptive, surgical sterilization (bilateral tubal ligation), vasectomized partner(s)) Exclusion Criteria: 1. Pelvic floor physical therapy, including muscle training and/or electrostimulation, in a clinical setting within 30 days prior to screening. 2. Pelvic floor trigger point injections, pudendal nerve block, or bladder hydrodistention within 30 days prior to screening 3. Subject weighs more than 330 pounds 4. Current urinary tract infection (UTI). If a subject has a confirmed symptomatic UTI at screening, per the investigator's clinical judgment, they will be deferred from screening until treatment is completed, and may resume once symptoms have resolved. 5. Pulmonary insufficiency, defined as difficulty breathing and fatigue, especially during exercise; heartbeat (palpitations); swelling of the legs or feet; dizziness or fainting; and/or bluish discoloration of the nails and/or lips (cyanosis) 6. Subject is currently receiving treatment for a malignant tumor that would interfere with study participation. 7. Any condition that causes a lack of normal skin sensation to the pelvis, buttocks, and lower extremities 8. History of Hunner's lesion in the medical record 9. Major metal implants such as: metal plates, screws, joint replacements, implanted cardiac pacemakers, drug pumps, neurostimulators, electronic implants, copper intrauterine devices, defibrillators, and metal implants in the pelvic area. Patients with other metal implants will be evaluated by the investigator for inclusion in the study. 10. Subject has a piercing between the waist and knees and is not willing to remove it before each treatment 11. Subject has used the BTL EMSELLA device previously 12. Currently participating in an investigational study that may impact study results or previously received an investigational drug or treatment within 30 days of the Screening Visit 13. Current or history of any physical condition that, in the investigator's opinion, might put the subject at risk or interfere with study results interpretation For Females Only: 14. Pregnant, or planning to become pregnant, at screening or anytime throughout the study period Note: For the sake of preserving scientific integrity, one or more of the eligibility criteria have been left off the list posted while the trial is ongoing. A full list of eligibility criteria will be posted upon completion of the trial.

Locations (1)

Beaumont Hospital-Royal Oak

Royal Oak, Michigan, United States

Outcomes

Primary Outcomes

The Change in Subject-reported Pain and Discomfort as Measured by the Visual Analog Scale (VAS)

Mean change in Pain VAS from baseline to end of treatment will be compared between the Emsella Chair group and the sham group. VAS is scored from 0-10, where 0 = no pain and 10 = worst possible pain. Value at week 8 minus the value at baseline was used to calculate change. Negative numbers indicate an improvement in pain, and positive numbers indicate a worsening pain.

Time frame: Baseline and week 8

Secondary Outcomes

The Change in Subject-reported Impression of CPP Severity as Measured by the Patient Global Impression of Severity Scale (PGI-S).

Change in subject-reported impression of CPP severity as measured by the Patient Global Impression of Severity scale (PGI-S). The subject will check the box that describes how their condition is now. This is a four point scale, with 1=normal, 2= mild, 3=moderate, and 4= severe. The value at week 12 minus the value at baseline was calculated. A positive change indicates a worsening condition, and a negative value indicated an improvement in condition.

Time frame: Baseline and week 12

The Number of Participants Reporting Significant Symptom Improvement as Measured by the Patient Global Impression of Improvement Scale (PGI-I)

Subject-reported impression of CPP improvement as measured by the Patient Global Impression of Improvement scale (PGI-I). The scale has 7 points with a lower number indicating improvement: (1=very much better, 2=much better, 3=a little better, 4=no change, 5=a little worse, 6-=much worse, 7= very much worse) to describe their chronic pelvic pain symptoms now versus prior to study treatment. We will report the number of individuals reporting a score of 1 or 2, very much better or much better (significantly improved).

Time frame: at 12 weeks

The Change in Subject-reported Impression of CPP Severity as Measured by Subject-reported Pelvic Floor Tenderness to Palpation During 4 Quadrant Pelvic Examination as Measured by VAS.

Data from ClinicalTrials.gov

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