Effect of electromyographic biofeedback as an add‐on to pelvic floor muscle exercises on neuromuscular outcomes and quality of life in postmenopausal women with stress urinary incontinence: A randomized controlled trial

• Published in: Neurourology and urodynamics Vol. 36; no. 8; pp. 2142 - 2147
• Main Authors: Bertotto, Adriane, Schvartzman, Renata, Uchôa, Silvana, Wender, Maria Celeste Osório
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-11-2017
• Subjects: Aged; Biofeedback; Biofeedback, Psychology - methods; Clinical trials; Electromyography; Electromyography - methods; Exercise Therapy - methods; Feedback; Female; Hormone replacement therapy; Humans; Middle Aged; Muscle contraction; Muscle strength; Muscle Strength - physiology; Muscles; Pelvic Floor - physiopathology; Pelvis; physiotherapy; Post-menopause; Postmenopause; Quality of Life; Surveys and Questionnaires; Treatment Outcome; Urinary incontinence; Urinary Incontinence - therapy; Urinary Incontinence, Stress - physiopathology; Urinary Incontinence, Stress - therapy; quality of life; physiotherapy
• ISSN: 0733-2467; 1520-6777
• DOI: 10.1002/nau.23258

Aims
To compare the efficacy of pelvic floor muscle exercises (PFME) with and without electromyographic biofeedback (BF) in increasing muscle strength, improving myoelectric activity, and improving pre‐contraction and quality of life in postmenopausal women with stress urinary incontinence.
Methods
Randomized controlled trial of 49 postmenopausal women with stress urinary incontinence. Participants were allocated across three groups: control, PFME alone, and PFME + BF. Forty‐five women completed the study (14 control, 15 PFME, 16 PFME + BF; mean age 58.26 years). Outcome assessment was carried out using digital palpation (modified Oxford grading scale), electromyography, and the International Consultation Incontinence Questionnaire‐Short Form (ICIQ‐SF) quality of life instrument. The treatment protocol consisted of eight twice‐weekly, 20‐min one‐on‐one sessions. Controls were assessed only at baseline and after 1 month.
Results
The PFME and PFME + BF groups exhibited significant increases in muscle strength (Oxford scale) (P < 0.0001), precontraction while coughing (P < 0.0001), maximum voluntary contraction, duration of endurance contraction, and ICIQ‐SF scores (P < 0.0001). PFME + BF was associated with significantly superior improvement of muscle strength, precontraction while coughing, maximum voluntary contraction, and duration of endurance contraction as compared to PFME alone (P < 0.05).
Conclusions
This preliminary study suggests that pelvic floor muscle training, with and without biofeedback, is associated with increased muscle strength, myoelectric activity, precontraction of pelvic floor muscles, and improved quality of life in postmenopausal women with stress urinary incontinence.