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Research Papers - Biofeedback

Do biofeedback devices such as perineometers and EMG devices help to strengthen the pelvic floor?

Four weeks of both intensive group physical therapy or individual biofeedback training followed by an unsupervised home exercise program for 2 months are effective therapies for female urinary stress incontinence and result in a significantly reduced nocturnal urinary frequency and improved subjective outcome. [..] Biofeedback therapy resulted in a better subjective outcome and higher contraction pressures of the pelvic floor muscles. Am J Phys Med Rehabil. 2001 Jul;80(7):494-502. Comparative analysis of biofeedback and physical therapy for treatment of urinary stress incontinence in women. Pages IH, Jahr S, Schaufele MK, Conradi E.

Biofeedback and pelvic muscle exercises are efficacious for sphincteric incompetence in older women. Benefits are maintained and improvement continues for at least 6 months postintervention. These therapies may be useful before considering invasive treatment. J Gerontol. 1993 Jul;48(4):M167-74.A comparison of effectiveness of biofeedback and pelvic muscle exercise treatment of stress incontinence in older community-dwelling women. Burns PA, Pranikoff K, Nochajski TH, Hadley EC, Levy KJ, Ory MG.

Combining biofeedback therapy with a vaginal probe (perineometer) helps patients identify the muscle, provides immediate feedback and assists the nurse and patient in assessing problem resolution. This article describes an intervention program using biofeedback, and measured Kegel's exercises on a small number of women with symptoms of stress incontinence. The lessening of symptoms became a major factor in continued compliance with the exercise program. Nurse Pract. 1985 Feb;10(2):28, 33-4, 46.Kegel's exercises with biofeedback therapy for treatment of stress incontinence. Burns PA, Marecki MA, Dittmar SS, Bullough B.

A relatively short-term intervention of PFME with sEMG-assisted biofeedback appeared to be helpful in relieving symptoms of SUI in premenopausal women and represents a reasonable conservative management option. Phys Ther. 2007 Feb;87(2):136-42. Epub 2007 Jan 9. Management of stress urinary incontinence with surface electromyography-assisted biofeedback in women of reproductive age. Rett MT, Simoes JA, Herrmann V, Pinto CL, Marques AA, Morais SS.

An intensive and EMG-biofeedback assisted PFMT is very effective. Often, avoidance of surgery is possible. Arch Gynecol Obstet. 2005 Dec;273(2):93-7. Epub 2005 Jul 6. EMG-biofeedback assisted pelvic floor muscle training is an effective therapy of stress urinary or mixed incontinence: a 7-year experience with 390 patients. Dannecker C, Wolf V, Raab R, Hepp H, Anthuber C.

Treatment of SUI with pelvic floor exercises associated to biofeedback caused significant changes in the parameters analyzed, with maintenance of good results 3 months after treatment. Int Braz J Urol. 2006 Jul-Aug;32(4):462-8; discussion 469.Pelvic floor exercises with biofeedback for stress urinary incontinence.Capelini MV, Riccetto CL, Dambros M, Tamanini JT, Herrmann V, Muller V.

This randomized controlled trial suggests that the home biofeedback method in PFT has a good success rate of 68.8%. The change achieved in leakage index after 12 weeks of training predicted an effective outcome for conservative treatment. Acta Obstet Gynecol Scand. 2004 Oct;83(10): 973-7. The effect of home biofeedback training on stress incontinence. Aukee P, Immonen P, Laaksonen DE, Laippala P, Penttinen J, Airaksinen O.

The findings of this study show that pelvic floor muscle activity is increased and the amount of leaked urine is decreased after 3 months of PFMT. These preliminary results show a significant improvement compared with the PFMT-alone group in PFMT outcome measures in patients using electromyography-assisted biofeedback training. Urology. 2002 Dec;60(6):1020-3; discussion 1023-4. Increase in pelvic floor muscle activity after 12 weeks' training: a randomized prospective pilot study. Aukee P, Immonen P, Penttinen J, Laippala P, Airaksinen O.

In our experience, patients with pelvic floor dyssynergia are likely to have continued benefit from biofeedback training [at the] one-year control. Dis Colon Rectum. 2004 Jan;47(1): 90-5. Epub 2004 Jan 2. Long-term study on the effects of visual biofeedback and muscle training as a therapeutic modality in pelvic floor dyssynergia and slow-transit constipation. Battaglia E, Serra AM, Buonafede G, Dughera L, Chistolini F, Morelli A, Emanuelli G, Bassotti G.

Biofeedback to teach pelvic floor muscle control, verbal feedback based on vaginal palpation, and a self-help booklet in a first-line behavioral training program all achieved comparable improvements in urge incontinence in community-dwelling older women. Patients' perceptions of treatment were significantly better for the 2 behavioral training interventions. JAMA. 2002 Nov 13;288(18):2293-9. Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial.Burgio KL, Goode PS, Locher JL, Umlauf MG, Roth DL, Richter HE, Varner RE, Lloyd LK

About half of the patients after PFR with biofeedback are still improved or cured after 26 months. Women should be counseled about the long-term efficacy and about the necessity of maintaining training. Eur J Obstet Gynecol Reprod Biol. 2002 Nov 15;105(2):181-5. Long-term efficacy of pelvic floor re-education with EMG-controlled biofeedback. Jundt K, Peschers UM, Dimpfl T.

Stress urinary incontinence is a common problem among women of all ages but may resolve with pelvic floor reeducation in many cases. Compliance to a regimen of pelvic floor muscle exercises is poor and many devices have been produced to make exercising these muscles more effective and interesting. This article describes a study in which two such devices -- vaginal cones and pressure biofeedback -- were compared with pelvic floor exercises alone. The results show that there is no statistically significant difference between the three modalities; all treatments produced significant improvement in symptoms and quality of life scores. Br J Community Nurs. 2001 May;6(5):230-7. Pelvic floor reeducation for stress incontinence: comparing three methods. Laycock J, Brown J, Cusack C, Green S, Jerwood D, Mann K, McLachlan Z, Schofield A.

These data suggest that self-selected healthy women with symptoms of urge, stress, and mixed incontinence can improve their symptoms and lower their severity index with a minimal intervention, comprehensive, self-directed home biofeedback continence system. J Wound Ostomy Continence Nurs. 2000 Jul;27(4):240-6. A self-directed home biofeedback system for women with symptoms of stress, urge, and mixed incontinence. Smith DB, Boileau MA, Buan LD .

This randomized controlled trial suggests that the home biofeedback method in PFT has a good success rate of 68.8%. The change achieved in leakage index after 12 weeks of training predicted an effective outcome for conservative treatment. Acta Obstet Gynecol Scand. 2004 Oct;83(10): 973-7. The effect of home biofeedback training on stress incontinence. Aukee P, Immonen P, Laaksonen DE, Laippala P, Penttinen J, Airaksinen O.

Home pelvic floor training with EMG-controlled biofeedback is efficient in 85% of patients in alleviating the symptoms of genuine stress and mixed incontinence without causing side effects. Int Urogynecol J Pelvic Floor Dysfunct. 1999; 10(1) :7-10. Treatment of female urinary incontinence with EMG-controlled biofeedback home training. Hirsch A, Weirauch G, Steimer B, Bihler K, Peschers U, Bergauer F, Leib B, Dimpfl T.

Thirty-seven women with stress incontinence were given biofeedback instruction on how to perform pelvic floor exercises correctly. After 3 months with home exercises 31 patients performed a new standardized pad-weighing test: 39% were objectively cured and 42% improved. After a mean of 2 years 15 patients were evaluated with another pad-weighing test: 27% were now objectively cured and 47% improved. A questionnaire showed that 78% had an exact knowledge about the location of the pelvic floor muscles and 47% were satisfied with their present situation, but only 58% performed daily exercises .Int Urogynecol J Pelvic Floor Dysfunct. 1998; 9(3):151-3. Efficacy of biofeedback in the treatment of urinary stress incontinence. Glavind K, Laursen B, Jaquet A.

All round improvement in incontinence levels, sexual function and quality of life. J Sex Med 2010. Feb 2. Sexual function and quality of life in women with urinary incontinence treated by a complete pelvic floor rehabilitation program (biofeedback, functional electrical stimulation, pelvic floor exercises and vaginal cones) Rivalta M and others.

Biofeedback provides better outcomes than unassisted pf exercises for patients with fecal incontinence. Dis Colon Rectum. 2009 Oct;52(10):1730-7. Randomized controlled trial shows biofeedback to be superior to pelvic floor exercises for fecal incontinence. Heymen S and others.

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