PURPOSE: To investigate the effect of adding biofeedback (BF) to the training of pelvic floor muscles (PFMT) for the treatment of stress urinary incontinence (SUI). METHODS: A prospective pilot study, randomized and controlled with women with SUI without sphincter deficiency, detected by urodynamic study and who performed the correct PFM contraction. Women with neuromuscular disorders and grade III and IV genital prolapse were excluded. Forty women were randomized into a CONTROL GROUP and BF Group. The PFMT protocol with BF equipment consisted of three sets of ten slow contractions (tonic), with a holding time of six to eight seconds at each contraction followed by a rest period of equal duration. After each sustained contraction, they performed three to four fast contractions (phasic) in the supine and standing position twice a week, for a total of 12 sessions. We evaluated the effect of adding BF to PFMT on quality of life using King's Health Questionnaire (KHQ) regarding urinary symptoms based on a voiding diary and regarding the function of pelvic floor muscles by digital palpation. The evaluation was performed initially and after 12 treatment sessions. Data are reported as mean and standard deviation. The Mann-Whitney test was used for the analysis of homogeneity and to determine differences between groups, and the Wilcoxon test was used to determine possible differences between the times of observation, with the level of significance set at 0.05. RESULTS: A significant decrease in the scores of the domains assessed by the KHQ was observed in the comparison between groups, except for the general health domain (BF Group: 32.8 ± 26.9 versus CONTROL GROUP: 48.4 ± 29.5, p<0.13). Accordingly, there was improvement in PFM function after treatment in the BF Group, regarding power (4.3 ± 0.8, p= 0.001), endurance (6.0 ± 2.2, p<0.001) and fast (9.3 ± 1.9, p=0.001). When comparing the groups, the BF Group showed a positive result regarding power (BF Group 4.3 ± 0.8 versus CONTROL GROUP 2.5 ± 0.9, p<0.001), endurance (6.0 ± 2.2 BF Group versus CONTROL GROUP 2.7 ± 1.9, p<0.001) and fast (BF Group 9.3 ± 1.9 versus CONTROL GROUP 4.6 ± 3.2, p<0.001). Reduction of nocturnal urinary frequency (1.2 ± 1.2 versus 0.7 ± 0.9, p=0.02) and of effort urine loss (1.5 ± 1.4 versus 0.6 ± 0.8, p=0.001) was observed in the BF Group. CONCLUSION: The addition of BF to the PFMT for the treatment of SUI, applied according to the protocol described, improved PFM function, reduced urinary symptoms, and improved of the quality of life.
RCT Entities:
PURPOSE: To investigate the effect of adding biofeedback (BF) to the training of pelvic floor muscles (PFMT) for the treatment of stress urinary incontinence (SUI). METHODS: A prospective pilot study, randomized and controlled with women with SUI without sphincter deficiency, detected by urodynamic study and who performed the correct PFM contraction. Women with neuromuscular disorders and grade III and IV genital prolapse were excluded. Forty women were randomized into a CONTROL GROUP and BF Group. The PFMT protocol with BF equipment consisted of three sets of ten slow contractions (tonic), with a holding time of six to eight seconds at each contraction followed by a rest period of equal duration. After each sustained contraction, they performed three to four fast contractions (phasic) in the supine and standing position twice a week, for a total of 12 sessions. We evaluated the effect of adding BF to PFMT on quality of life using King's Health Questionnaire (KHQ) regarding urinary symptoms based on a voiding diary and regarding the function of pelvic floor muscles by digital palpation. The evaluation was performed initially and after 12 treatment sessions. Data are reported as mean and standard deviation. The Mann-Whitney test was used for the analysis of homogeneity and to determine differences between groups, and the Wilcoxon test was used to determine possible differences between the times of observation, with the level of significance set at 0.05. RESULTS: A significant decrease in the scores of the domains assessed by the KHQ was observed in the comparison between groups, except for the general health domain (BF Group: 32.8 ± 26.9 versus CONTROL GROUP: 48.4 ± 29.5, p<0.13). Accordingly, there was improvement in PFM function after treatment in the BF Group, regarding power (4.3 ± 0.8, p= 0.001), endurance (6.0 ± 2.2, p<0.001) and fast (9.3 ± 1.9, p=0.001). When comparing the groups, the BF Group showed a positive result regarding power (BF Group 4.3 ± 0.8 versus CONTROL GROUP 2.5 ± 0.9, p<0.001), endurance (6.0 ± 2.2 BF Group versus CONTROL GROUP 2.7 ± 1.9, p<0.001) and fast (BF Group 9.3 ± 1.9 versus CONTROL GROUP 4.6 ± 3.2, p<0.001). Reduction of nocturnal urinary frequency (1.2 ± 1.2 versus 0.7 ± 0.9, p=0.02) and of effort urine loss (1.5 ± 1.4 versus 0.6 ± 0.8, p=0.001) was observed in the BF Group. CONCLUSION: The addition of BF to the PFMT for the treatment of SUI, applied according to the protocol described, improved PFM function, reduced urinary symptoms, and improved of the quality of life.
Authors: Suzanne Hagen; Carol Bugge; Sarah G Dean; Andrew Elders; Jean Hay-Smith; Mary Kilonzo; Doreen McClurg; Mohamed Abdel-Fattah; Wael Agur; Federico Andreis; Joanne Booth; Maria Dimitrova; Nicola Gillespie; Cathryn Glazener; Aileen Grant; Karen L Guerrero; Lorna Henderson; Marija Kovandzic; Alison McDonald; John Norrie; Nicole Sergenson; Susan Stratton; Anne Taylor; Louise R Williams Journal: Health Technol Assess Date: 2020-12 Impact factor: 4.014
Authors: Maria Cláudia Bicudo Fürst; Rafaela Rosalba de Mendonça; Alexandre Oliveira Rodrigues; Leandro Luongo de Matos; Antônio Carlos Lima Pompeo; Carlos Alberto Bezerra Journal: Einstein (Sao Paulo) Date: 2014-04
Authors: Suzanne Hagen; Andrew Elders; Susan Stratton; Nicole Sergenson; Carol Bugge; Sarah Dean; Jean Hay-Smith; Mary Kilonzo; Maria Dimitrova; Mohamed Abdel-Fattah; Wael Agur; Jo Booth; Cathryn Glazener; Karen Guerrero; Alison McDonald; John Norrie; Louise R Williams; Doreen McClurg Journal: BMJ Date: 2020-10-14