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Question clinique
Does biofeedback of pelvic floor muscle contraction improve incontinence symptoms when added to a structured training program in women with stress or mixed urinary incontinence?
L’Essentiel
Biofeedback, when added to a structured exercise program of pelvic floor muscle training, does not provide additional symptom control for women with stress or mixed urinary incontinence. This study did not have a control group of women given basic instruction without additional training. 2b
Référence
Plan de l'etude: Randomized controlled trial (single-blinded)
Financement: Government
Cadre: Outpatient (specialty)
Sommaire
These investigators enrolled 600 women (average age 48 years) who initially sought care for stress or mixed urinary incontinence at 1 of 23 continence care centers. The women were randomized, using concealed allocation, to receive structured pelvic floor muscle training with or without electromyographic feedback, which captures the electrical activity of the pelvic floor muscles. Pelvic floor muscle training consisted of 6 appointments with a continence therapist and an individualized exercise program to be continued at home. Patients in the feedback group also used electromyographic feedback during appointments and at home. Using a self-administered incontinence questionnaire, approximately half the women had severe incontinence (score of at least 13 out of a possible 21). At 6, 12, and 24 months, scores in both groups dropped similarly, from baselines of 12.3 and 12.5 to 8.2 and 8.5. Quality of life, voiding, or incontinence scores were not different between the 2 groups. The study doesn't answer the question of whether the biofeedback device can be used in lieu of the structured training provided in this study.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Commentaires
biofeedback
sounds complicated
biofeedback vs pelvic floor muscle training
I have always felt that biofeedback training would be additional to pelvic floor exercises but apparently not in this study