Biofeedback Training Improves Swallowing in a Unique Case of Upper Esophageal Sphincter Hypotonicity.

Hypotonicity of the upper esophageal sphincter (UES) has been reported only two times previously in the literature, with no reports of treatment options for this rarity. We present a third case of hypotonic UES found during high-resolution pharyngeal manometry. Although the patient had nearly absent resting pressures of the UES, pressures during and post-swallow were normal. It was hypothesized that the patient might be able to increase pre-swallow UES pressure using biofeedback. Using a chin up/out maneuver during manometry, the patient was able to achieve a more normal swallow pressure pattern. This case also highlights the need to complete manometry alongside other swallow imaging techniques for effective treatment planning and patient outcomes. Laryngoscope, 131:E1567-E1569, 2021.

Tissue Structure and Edema Fluid Events During Treatment of Lymphedema of Limbs with a Manual Pressure-Calibrated Device, Linforoll.

Background: Linforoll is a device composed of handpiece with roller and pressure sensor connected wireless to the computer displaying the pressure curve of the applied force. In a previous study, we proved it to regulate the applied force according to the hydromechanic conditions of the massaged tissues. Standardization of massage based on applied force was repeatable in the same patient; it decreased limb volume and provided evident increase in tissue elasticity. Methods and Results: In this study, we measured additional parameters useful for the understanding of tissue and fluid events and approval of the device for general practice. These were skin stiffness, subcutaneous tissue stiffness independent of skin, skin water concentration, changes in skin temperature, skin capillary blood flow, subcutaneous tissue fluid pressure, volume of the moved edema fluid, and visualization of movement on indocyanine green (ICG) lymphography. Measurements were done before and during the massage. The data were obtained from a group of 20 patients with obstructive lymphedema of lower limbs during the Linforoll massage. There was a lack of significant changes in skin stiffness, skin water concentration, skin surface temperature, and capillary blood flow, but evident increase in the subcutaneous tissue elasticity (tonometry) and lymphography-shown flow of the edema fluid. Conclusions: The skin tissue hydromechanic parameters remained normal proving lack of destructive changes under high massaging pressures. The obtained data evidently show that not the skin but the subcutis accumulated edema fluid that can successfully be moved proximally under pressures of 80-120 mmHg.

An anti-barotrauma system for preventing barotrauma during hyperbaric oxygen therapy.

In the present study, a tympanometry-based anti-barotrauma (ABT) device was designed using eardrum admittance measurements to develop an objective method of preventing barotrauma that occurs during hyperbaric oxygen (HBO2) therapy. The middle ear space requires active equalization, and barotrauma of these tissues during HBO2therapy constitutes the most common treatment-associated injury. Decongestant nasal sprays and nasal steroids are used, but their efficacy is questionable to prevent middle ear barotrauma (MEB) during HBO2 treatment. Accordingly, a tympanometry-based ABT device was designed using eardrum admittance measurements to develop an objective method for preventing MEB, which causes pain and injury, and represents one of the principal reasons for patients to stop treatment. This study was conducted to test a novel technology that can be used to measure transmembrane pressures, and provide chamber attendants with real-time feedback regarding the patient's equalization status prior to the onset of pain or injury. Eardrum admittance values were measured according to pressure changes inside a hyperbaric oxygen chamber while the system was fitted to the subject. When the pressure increased to above 200 daPa, eardrum admittance decreased to 16.255% of prepressurization levels. After pressure equalization was achieved, eardrum admittance recovered to 95.595% of prepressurization levels. A one-way repeated measures analysis of variance contrast test was performed on eardrum admittance before pressurization versus during pressurization, and before pressurization versus after pressure equalization. The analysis revealed significant differences at all points during pressurization (P⟨0.001), but no significant difference after pressure equalization was achieved. This ABT device can provide objective feedback reflecting eardrum condition to the patient and the chamber operator during HBO2 therapy.

Quantitative tissue parameters of Achilles tendon and plantar fascia in healthy subjects using a handheld myotonometer.

OBJECTIVE: The aim of the study was to examine the quantitative tissue properties of the Achilles tendon and plantar fascia using a handheld, non-invasive MyotonPRO device, in order to generate normal values and examine the biomechanical relationship of both structures. DESIGN: Prospective study of a large, healthy sample population. PARTICIPANTS: The study sample included 207 healthy subjects (87 males and 120 females) for the Achilles tendon and 176 healthy subjects (73 males and 103 females) for the plantar fascia. For the correlations of the tissue parameters of the Achilles tendon and plantar fascia an intersection of both groups was formed which included 150 healthy subjects (65 males and 85 females). INTERVENTIONS: All participants were measured in a prone position. Consecutive measurements of the Achilles tendon and plantar fascia were performed by MyotonPRO device at defined sites. RESULTS: For the left and right Achilles tendons and plantar fasciae all five MyotonPRO parameters (Frequency [Hz], Decrement, Stiffness [N/m], Creep and Relaxation Time [ms]) were calculated of healthy males and females. The correlation of the tissue parameters of the Achilles tendon and plantar fascia showed a significant positive correlation of all parameters on the left as well as on the right side. CONCLUSIONS: The MyotonPRO is a feasible device for easy measurement of passive tissue properties of the Achilles tendon and plantar fascia in a clinical setting. The generated normal values of the Achilles tendon and plantar fascia are important for detecting abnormalities in patients with Achilles tendinopathy or plantar fasciitis in the future. Biomechanically, both structures are positively correlated. This may provide new aspects in the diagnostics and therapy of plantar fasciitis and Achilles tendinopathy.

Increased yield pressure in the anal canal during sacral nerve stimulation: a pilot study with the functional lumen imaging probe.

BACKGROUND: Sacral nerve stimulation (SNS) is a well-established treatment for fecal incontinence but its mode of action remains obscure. Anal sphincter function is usually evaluated with manometry but resistance to distension may be a more appropriate parameter than luminal pressure. The functional lumen imaging probe allows detailed description of distension properties of the anal canal. Our objective in this study was to characterize the impact of SNS on distension properties of the anal canal in patients with idiopathic fecal incontinence. METHODS: We studied 10 women (median age 64 [44-79] years) with idiopathic fecal incontinence at baseline and during SNS. The luminal geometry of the anal canal was examined with the FLIP at rest and during squeeze and the distensibility of the anal canal was investigated during filling of the bag. KEY RESULTS: All patients were successfully treated with SNS and the mean Wexner Incontinence Score was reduced from 14.9 ± 4 to 7.1 ± 4.8 (P<.001). The pressure required to open the narrowest point of the anal canal during distension (yield pressure) increased from 14.5 ± 12.2 mmHg at baseline to 20.5 ± 13.3 mmHg during SNS (P<.01). The pressure-strain elastic modulus increased non-significantly from 2.2 ± 0.5 to 2.9 ± 1.6 kPa, indicating increased stiffness of the anal canal. CONCLUSION AND INFERENCES: The yield pressure and the resistance to distension increased in response to SNS for idiopathic fecal incontinence. This will inevitably increase the resistance to flow through the anal canal, which may contribute to the benefits of sacral nerve stimulation.

Differential Intracochlear Sound Pressure Measurements in Human Temporal Bones with an Off-the-Shelf Sensor.

The standard method to determine the output level of acoustic and mechanical stimulation to the inner ear is measurement of vibration response of the stapes in human cadaveric temporal bones (TBs) by laser Doppler vibrometry. However, this method is reliable only if the intact ossicular chain is stimulated. For other stimulation modes an alternative method is needed. The differential intracochlear sound pressure between scala vestibuli (SV) and scala tympani (ST) is assumed to correlate with excitation. Using a custom-made pressure sensor it has been successfully measured and used to determine the output level of acoustic and mechanical stimulation. To make this method generally accessible, an off-the-shelf pressure sensor (Samba Preclin 420 LP, Samba Sensors) was tested here for intracochlear sound pressure measurements. During acoustic stimulation, intracochlear sound pressures were simultaneously measurable in SV and ST between 0.1 and 8 kHz with sufficient signal-to-noise ratios with this sensor. The pressure differences were comparable to results obtained with custom-made sensors. Our results demonstrated that the pressure sensor Samba Preclin 420 LP is usable for measurements of intracochlear sound pressures in SV and ST and for the determination of differential intracochlear sound pressures.

Providing time-discrete gait information by wearable feedback apparatus for lower-limb amputees: usability and functional validation.

Here we describe a novel wearable feedback apparatus for lower-limb amputees. The system is based on three modules: a pressure-sensitive insole for the measurement of the plantar pressure distribution under the prosthetic foot during gait, a computing unit for data processing and gait segmentation, and a set of vibrating elements placed on the thigh skin. The feedback strategy relies on the detection of specific gait-phase transitions of the amputated leg. Vibrating elements are activated in a time-discrete manner, simultaneously with the occurrence of the detected gait-phase transitions. Usability and effectiveness of the apparatus were successfully assessed through an experimental validation involving ten healthy volunteers.

Fiber-optic combined FPI/FBG sensors for monitoring of radiofrequency thermal ablation of liver tumors: ex vivo experiments.

We present a biocompatible, all-glass, 0.2 mm diameter, fiber-optic probe that combines an extrinsic Fabry-Perot interferometry and a proximal fiber Bragg grating sensor; the probe enables dual pressure and temperature measurement on an active 4 mm length, with 40 Pa and 0.2°C nominal accuracy. The sensing system has been applied to monitor online the radiofrequency thermal ablation of tumors in liver tissue. Preliminary experiments have been performed in a reference chamber with uniform heating; further experiments have been carried out on ex vivo porcine liver, which allowed the measurement of a steep temperature gradient and monitoring of the local pressure increase during the ablation procedure.

A real-time auditory feedback system for retraining gait.

Stroke is the third leading cause of death in the United States and the principal cause of major long-term disability, incurring substantial distress as well as medical cost. Abnormal and inefficient gait patterns are widespread in survivors of stroke, yet gait is a major determinant of independent living. It is not surprising, therefore, that improvement of walking function is the most commonly stated priority of the survivors. Although many such individuals achieve the goal of walking, the caliber of their walking performance often limits endurance and quality of life. The ultimate goal of the research presented here is to use real-time auditory feedback to retrain gait in patients with chronic stroke. The strategy is to convert the motion of the foot into an auditory signal, and then use this auditory signal as feedback to inform the subject of the existence as well as the magnitude of error during walking. The initial stage of the project is described in this paper. The design and implementation of the new feedback method for lower limb training is explained. The question of whether the patient is physically capable of handling such training is explored.

Design of an intelligent and personalised shunting system for hydrocephalus.

Hydrocephalus is a neurological disease that manifests itself in an elevated fluid pressure within the brain, and if left untreated, may be fatal. It is currently treated using shunt implants, which consist of a mechanical valve and tubes that regulate the pressure of cerebrospinal fluid (CSF) by draining excess fluid into the abdomen. Hydrocephalus shunting systems are no longer expected simply to regulate the intracranial pressure (ICP), but also to offer the option of regaining independence of the shunt. Additionally, they could offer personalised valve management which is one of the main limitations of current shunts. This paper describes the design of a multi-agent system for an intelligent and personalised CSF management system. Patient feedback and intracranial pressure readings will play important roles in the process of CSF regulation and weaning, introduces an element of personalisation to the treatment. The new shunting system would deliver both reactive and goal-driven solutions for the treatment, at the same time the intelligent part of the system will be monitoring how well the shunt is performing. These tasks can be achieved by implementing an agent approach in designing this system. Such system would help us to understand more about the dynamics of hydrocephalus.

Pressure sensor-based tongue-placed electrotactile biofeedback for balance improvement--biomedical application to prevent pressure sores formation and falls.

We introduce the innovative technologies, based on the concept of "sensory substitution", we are developing in the fields of biomedical engineering and human disability. Precisely, our goal is to design, develop and validate practical assistive biomedical and/or technical devices and/or rehabilitating procedures for persons with disabilities, using artificial tongue-placed tactile biofeedback systems. Proposed applications are dealing with: (1) pressure sores prevention in case of spinal cord injuries (persons with paraplegia, or tetraplegia); and (2) balance control improvement to prevent fall in older and/or disabled adults. This paper describes the architecture and the functioning principle of these biofeedback systems and presents preliminary results of two feasibility studies performed on young healthy adults.

Cuffless and noninvasive measurement of systolic blood pressure, diastolic blood pressure, mean arterial pressure and pulse pressure using radial artery tonometry pressure sensor with concept of Korean traditional medicine.

Parameters for noninvasive diagnosis and monitoring of cardiovascular disease. We developed a new method to measure blood pressure (BP) noninvasively without cuff. In Korean traditional medicine, the degree of the pulse depth is one of the important criteria to diagnosis. We combined this concept with pulse wave analysis. With clinical data obtained from 163 subjects, we selected APm (applied pressure which has a maximum value of pulse wave), elasticity of wrist tissue, depth of blood vessel, cardiac output and h1 as parameters to estimate blood pressure. And with the parameters, we induced multi regression equation of systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and pulse pressure (PP). And the probabilities of these parameters to explain SBP, DBP, and MAP were 89.5%, 91.1% and 94.6%, respectively. To estimate PP, we added h1 to the parameters to explain PP was 97.5%. We compared the estimated SBP, DBP, MAP and PP through the multiple regression equations to the actual measured SBP, DBP, MAP and PP through the wrist type BP meter. Differences were (+/- SD) 0.38 +/- 9.95, -1.0 +/- 8.2, 0.02 +/- 6.9 and 0.05 +/- 5.9mmHg for SBP, DBP, MAP and PP, respectively. According to the American National Standard for Electronic or Automated Sphygmomanometers, the mean difference (MD) should be +/- 5mmHg or less with a standard deviation (SD) of +/- 8mmHg or less. Hence, the results of MAP and PP were within the limits for the AAMI SP 10 criteria and the results of SBP and DBP were not within the limits for the AAMI SP 10 criteria. The preliminary results indicate the results are quite reliable and promising.

[Use of pharyngeal pressure measurement to localize the source of snoring]. / Einsatz der ösophagopharyngealen Druckmessung zur Topodiagnostik des Schnarchens.

BACKGROUND: Depending on age and gender up to 60 % of the population snore regularly. As simple snoring is more a social than a medical problem, unlike OSAS, CPAP-therapy or multilevel surgery are not appropriate therapies for snoring. But alternative therapies, such as laser-assisted uvulopalatoplasty (LAUP) or uvulopalatopharyngoplasty (UPPP) address distinct sites of the pharynx. Therefore a correct identification of the snoring-source should optimise the selection of patients and improve the outcome of therapy. As there is no commonly recommended tool for identifying the snoring-source, the use of a new technique, based on pharyngeal pressure measurement, was tested. METHODS: 25 patients with suspected OSAS had standard polysomnography recordings during two nights with esophagopharyngeal pressure measurement on the second night. The pressure probe had 5 pharyngeal and 1 esophageal transducers. The curves of the pharyngeal pressure were examined for quick pressure changes superimposed on the slow pressure-changes caused by breathing. The appearance of these quick pressure changes was documented for each transducer throughout the whole night. RESULTS: The average (+/- SD) Apnea-Hypopnea-Index in the patients was 28.3 +/- 24.8. 17 patients (68 %) had an AHI of more than 10. All patients showed heavy snoring. 23 patients (92 %) showed a high frequency, sawtooth-pattern, superimposed on the slow breathing rhythm in at least one channel and in association with snoring. 91 % of the patients showed a sawtooth pattern in more than one channel, but the pattern was always more pronounced in one channel compared to others. The sawtooth-pattern of the highest amplitude was seen in the pressure curves from the velum in 56 % of the patients, from the tonsils in 24 %, and from the tonguebase in 12 % of the patients. CONCLUSIONS: Quick pressure changes from distinctive pharyngeal pressure transducers during snoring are common in OSAS patients and may indicate the source of snoring. Further investigations have to show whether this assumption is correct, and whether the quick pressure changes are also apparent in simple snorers.

Validity of a new feedback method for the VEMP test.

CONCLUSIONS: We used a feedback method, based on a blood pressure manometer with inflatable cuff, to control the sternocleidomastoid muscle (SCM) contraction. To obtain comparable left-right VEMP responses, it is necessary (1) to determine which cuff pressures on both sides yield identical mean rectified voltage (MRV) values of the SCM contraction and (2) to apply these cuff pressures during the VEMP test. OBJECTIVE: To investigate the effect of the SCM muscle contraction variability on the VEMP variables when applying the feedback method. MATERIALS AND METHODS: Subjects pushed with their jaw against the hand-held inflated cuff to generate cuff pressures of subsequently 30, 40 and 50 mmHg during a MRV and VEMP measurement. RESULTS: When analyzing the relationship between the applied cuff pressures and the MRV values/VEMP amplitudes, we showed that (1) there was a linear relationship, (2) there was no side effect and (3) there was an interaction effect between 'side' and 'subject'. There was neither a side effect, nor an effect of the applied cuff pressure when considering the p13 latencies. As for the n23 values, there was no side effect but there was a significant difference when comparing the n23 latencies at cuff pressures of 30 vs 40 mmHg/50 mmHg.

The effects of breath control on maximum force and IAP during a maximum isometric lifting task.

BACKGROUND: Evidence exists linking breath control to increases in intra-abdominal pressure and lumbar stability. Weight-lifting experts use this evidence as a rationale to suggest that increases in lumbar stability afforded by specific forms of breath control can influence the amount of force produced by the trunk. No studies have examined this issue. Therefore, this study determined whether voluntary control of the breath is related to maximal trunk extension force and if maximal force is correlated to intra-abdominal pressure. METHODS: Thirteen men and 20 women (mean age: 25.6 years (5.5)) performed a maximal isometric trunk exertion in a knee bent posture using voluntary breath conditions: (1) inhalation prior to exertion with hold during exertion; (2) exhalation prior to exertion with hold during the exertion; (3) inhalation prior to the exertion with exhalation during the exertion. A subset of subjects (n=11) were also simultaneously measured for intra-abdominal pressure. Separate repeated measures ANOVA were used to determine the effects of breath conditions on force and intra-abdominal pressure. Pearson coefficients were used to determine the correlation between force and intra-abdominal pressure. FINDINGS: Breath control did not significantly affect isometric force production (P=.089) but did affect intra-abdominal pressure (P=.003). Correlations between force and intra-abdominal pressure in each breath condition were low (range: 0.152-0.583). INTERPRETATION: Although breath control was shown to influence intra-abdominal pressure, it does not appear to influence isometric trunk extension force in a knees bent position. Further, the intra-abdominal pressure produced in such efforts appears to be unrelated to the amount of force produced.

The effects of breath control on intra-abdominal pressure during lifting tasks.

STUDY DESIGN: This was a repeated measures study examining 11 asymptomatic subjects while performing dynamic lifting using various postures, loads, and breath control methods. OBJECTIVES: To examine the effects of breath control on magnitude and timing of intra-abdominal pressure during dynamic lifting. SUMMARY OF BACKGROUND DATA: Intra-abdominal pressure has been shown to increase consistently during static and dynamic lifting tasks. The relationship between breath control and intra-abdominal pressure during lifting is not clear. METHODS: Eleven healthy subjects were tested using lifting trials consisting of two levels of posture and load and four levels of breath control (natural breathing, inhalation-hold, exhalation-hold, inhalation-exhalation). Intra-abdominal pressure was measured using a microtip pressure transducer placed within the stomach through the nose. Timing of intra-abdominal pressure was determined relative to lift-off of the weights. Repeated measures analysis of variance was used to determine the effect of breath control, posture, and load on intra-abdominal pressure magnitude and timing. RESULTS: There was a significant effect of breath control (P < 0.018) and load (P < 0.002), but not of posture (P < 0.434), on intra-abdominal pressure magnitude. The inhalation-hold form of breath control produced significantly greater peak intra-abdominal pressure than all other forms of breath control (P < 0.000 for all comparisons). No other comparisons among levels of breath were significantly different. No significant main effects of breath control were found relative to intra-abdominal pressure timing. CONCLUSIONS: Breath control is a significant factor in the generation of intra-abdominal pressure magnitude during lifting tasks. The effects of respiration should be controlled in studies analyzing intra-abdominal pressure during lifting.

Evaluation of anorectal functions of children with anorectal malformations using fecoflowmetry.

BACKGROUND/PURPOSE: A simple and objective method evaluating the bowel functions of patients with anorectal anomalies is necessary. The authors applied fecoflowmetry and saline enama test for patients with anorectal anomalies to evaluate the fecodynamics and anorectal motilities in these children. METHODS: The bowel functions of 16 patients who underwent repair for anorectal malformations and 5 normal controls were evaluated by saline enema test and fecoflowmetry. The correlations between the clinical scores for the bowel functions and the parameters in fecodynamic studies were investigated. RESULTS: Seven of 16 patients exhibited periodical contractions of the rectum synchronized with relaxations of the anal canal during saline infusion as did the controls and had significantly higher clinical scores than the other patients. Two patients with severe chronic constipation lacked rectal contractions. Among the fecoflowmetric parameters, the maximum flow, average flow, and tolerable volume of saline infused into the rectum were significantly lower in the patients with low clinical scores than those of the controls. The maximal squeeze pressure and resting anal pressure were not significantly different between the patients and controls. CONCLUSION: Fecodynamic studies, such as fecoflowmetry and saline enema test, help in obtaining clinical indicators for the bowel functions of patients with anorectal anomalies.

Ball tonometry: a rapid, nondestructive method for measuring cell turgor pressure in thin-walled plant cells.

In this article we describe a new method for the determination of turgor pressures in living plant cells. Based on the treatment of growing plant cells as thin-walled pressure vessels, we find that pressures can be accurately determined by observing and measuring the area of the contact patch formed when a spherical glass probe is lowered onto the cell surface with a known force. Within the limits we have described, we can show that the load (determined by precalibration of the device) divided by the projected area of the contact patch (determined by video microscopy) provides a direct, rapid, and accurate measure of the internal turgor pressure of the cell. We demonstrate, by parallel measurements with the pressure probe, that our method yields pressure data that are consistent with those from the pressure probe. Also, by incubating target tissues in stepped concentrations of mannitol to incrementally reduce the turgor pressure, we show that the pressures measured by tonometry accurately reflect the predicted changes from the osmotic potential of the bathing medium. The advantages of this new method over the pressure probe are considerable, however, in that we can move rapidly from cell to cell, taking measurements every 20 s. In addition, the nondestructive nature of the method means that we can return to the same cell repeatedly for periodic pressure measurements. The limitations of the method lie in the fact that it is suitable only for superficial cells that are directly accessible to the probe and to cells that are relatively thin walled and not heavily decorated with surface features. It is also not suitable for measuring pressures in flaccid cells.

Study of the effect of external urethral sphincter contraction on the mechanical activity of the ureterovesical junction and urinary bladder: recognition of the sphinctero-ureterovesical reflex.

OBJECTIVES: To study the effect of external urethral sphincter (EUS) contraction on the urinary bladder and ureterovesical junction (UVJ). METHODS: The study was comprised of 9 healthy volunteers (7 men, 2 women; mean age 40.8 +/- 6.6 years). A manometric catheter was introduced into each of the two UVJs and urinary bladder. The EUS was made to contract by voluntary squeezing and by electromyographic stimulation with a needle electrode inserted into the sphincter. The response of the bladder and the UVJs to EUS contraction was determined before and after anesthetization of the EUS, bladder, and the two UVJs, each at a different time. RESULTS: On voluntary squeezing or electromyographic needle stimulation of the EUS, the pressure in both the UVJs and the urinary bladder showed a significant drop (P < 0.05 in both instances). There was no pressure response in the UVJs or in the urinary bladder 10 minutes after separate anesthetization of either the EUS or the UVJs and the bladder; however, 2 hours later, the pressure response was similar to that before anesthesia (P > 0.05). CONCLUSIONS: Bladder and UVJ relaxation on EUS contraction postulate a reflex relationship that was reproducible and absent on anesthetization of either of the suggested two arms of the reflex: the EUS on one end and the bladder and UVJs on the other end. We call this reflex the "sphinctero-ureterovesical reflex." Further studies are needed to evaluate the possible role of this reflex in the micturition mechanism and disorders.

[Incontinence after ileo-anal pouch anastomosis--diagnostic criteria and therapeutic sequelae]. / Kontinenzstörungen nach ileoanaler Pouchanlage--diagnostische Kriterien und therapeutische Folgerungen.

After ileo-pouch-anal anastomosis (IPAA) there is an increased risk of incontinence due to intraoperative damage of the anal sphincter. We present a new concept to identify a potential incontinence prior to the closure of ileostomy by clinical and anal manometrical examinations. In 11 of 121 (9.1%) patients we diagnosed a potential incontinence. By biofeedback training we could achieve in this way a sufficient continence after the closure of ileostomy. After an average of 5.0 +/- 4.3 months of training rest pressures improved from 19.3 +/- 2.1 mmHg to 33.0 +/- 3.5 mmHg and squeeze pressures from 60.5 +/- 27.7 mmHg to 93.5 +/- 17.3 mmHg. Prior to IPAA patients with potential incontinence show significantly reduced rest pressures of 51.0 +/- 18.4 mmHg.