Electromyographic Biofeedback for Stress Urinary Incontinence or Pelvic Floor Dysfunction in Women: A Systematic Review and Meta-Analysis

Wu, Xiaoli; Zheng, Xiaodong; Yi, Xiaohong; Peng, Lai; Lan, Yuping

doi:10.1007/s12325-021-01831-6

Cited by 39 publications

(26 citation statements)

References 24 publications

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“…These results are in line with our data from a previous work, in which we presented the improvement in the level of neuromuscular activity of PFM after using one-time EMG biofeedback (Bludnicka et al, 2020). Our outcomes correspond to the conclusion from a systematic review and meta-analysis by Wu et al (2021) that adding EMG biofeedback to standard PFM training improves its effectiveness in the therapy of pelvic floor dysfunctions. Similar findings were presented also by other authors analyzing relationships between EMG biofeedback and pelvic pain in various populations (Wagner et al, 2022).…”

Section: Discussionsupporting

confidence: 92%

“…Our outcomes correspond to the conclusion from a systematic review and meta-analysis by Wu et al (2021) that adding EMG biofeedback to standard PFM training improves its effectiveness in the therapy of pelvic floor dysfunctions. Similar findings were presented also by other authors analyzing relationships between EMG biofeedback and pelvic pain in various populations ( Wagner et al, 2022 ).…”

Section: Discussionsupporting

confidence: 86%

“…On the other hand, some authors underlined that initially women might be unable to contract PFM properly ( Kandadai et al, 2015 ; Vermandel et al, 2015 ; Szumilewicz et al, 2019b ). Therefore, some of them may need external support to achieve better outcomes, especially in the therapies of stress UI or other pelvic floor dysfunctions ( Wu et al, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

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The influence of one-time biofeedback electromyography session on the firing order in the pelvic floor muscle contraction in pregnant woman–A randomized controlled trial

Błudnicka

Piernicka²,

Kortas³

et al. 2022

Front. Hum. Neurosci.

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Many women are initially unable to contract the pelvic floor muscles (PFMs) properly, activating other muscle groups before, or instead of, PFM. Numerous authors have proved that biofeedback can be an ideal tool supporting learning of the PFM contraction. However, there is currently a lack of scientific data on how many biofeedback sessions are necessary in this educational process. In this study we aimed at assessing the effects of one-time electromyography (EMG) biofeedback session on the order in which PFM are activated (so called firing order) during conscious contractions in relation to selected synergistic muscles in pregnant, continent women. A randomized controlled trial was conducted in 90 healthy nulliparous women with uncomplicated pregnancies and without diagnosed urinary incontinence. We divided the participants into a biofeedback group (50) and a control group (40). They were, respectively: 30 ± 4 and 30 ± 4 years old, at their 23 ± 5 or 25 ± 7 week of gestation and presented 23 ± 5 or 24 ± 5 kg/m2 BMI value (M + SD). Surface EMG with vaginal probes has been used to assess the PFM firing order in selected tasks: in five 3-s maximal contractions (quick flicks), five 10-s contractions, and in a 60-s contraction (static hold). We used the 1–5 scale, where “1” meant the best score, awarded when PFM was activated first in order. The most important finding of our study is that a single EMG biofeedback substantially improved the PFM contractions in pregnant women. First, when applying one-time biofeedback session, more women maintained correct technique or improved it in the second assessment, compared to the control group (73 vs. 65%). Secondly, using the quantitative and qualitative analysis with the Chi-square McNamara B/C test, in the biofeedback group we observed a statistically significant improvement of PFM firing order in four tasks: in the first quick flicks (p = 0.016), third quick flicks (p = 0.027), fifth quick flicks (p = 0.008), and in the first 10-s contractions (p = 0.046). In the control group we observed better outcome only in one motor task: in the fourth 10-s contraction (p = 0.009). Given the positive effects of a single session of EMG biofeedback on the firing order in the PFM contractions, it should be recommended for pregnant women without urinary incontinence to teach them how to perform PFM exercises correctly.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The influence of one-time biofeedback electromyography session on the firing order in the pelvic floor muscle contraction in pregnant woman–A randomized controlled trial

Błudnicka

Piernicka²,

Kortas³

et al. 2022

Front. Hum. Neurosci.

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“…Biofeedback may be used to teach women how to contract the correct muscles, when and how to contract the muscles to avoid leakage, how to measure whether the muscular contraction is improving over time, and as a "trainer" and direction for repetitive exercise. [15][16][17][18][19] Electromyographic or pressure biofeedback can be regarded as an adjuvant to PFMT for the management of stress urinary incontinence (SUI) as it is used to help train for accuracy, isolation, and strength of the PFM. 18 However, PFMT, and therefore the role of BF, may be different in patients with urge incontinence.…”

mentioning

confidence: 99%

Biofeedback‐assisted pelvic floor muscle training and pelvic electrical stimulation in women with overactive bladder: A systematic review and meta‐analysis of randomized controlled trials

Leonardo¹,

Seno

Mirza

et al. 2022

Neurourology and Urodynamics

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Objective This meta‐analysis aims to compare biofeedback‐assisted pelvic muscle floor training (PFMT) and pelvic electrical stimulation (ES) as an intervention group, with PFMT or bladder training (BT) as the control group, in women with an overactive bladder (OAB). Method PubMed, Cochrane, CINAHL, EMBASE, and Scopus were systematically searched for randomized controlled trials (RCTs) published up to November 2021. The RCTs were screened for our eligibility criteria and quality was evaluated using the Cochrane Risk Index of Bias tools. The outcomes were changes in quality of life (QoL), episodes of incontinence, and the number of participants cured/improved. Results Eight studies involving 562 patients (comprising 204 patients with biofeedback‐assisted PFMT, 108 patients with pelvic ES, and 250 patients who received PFMT alone or BT and lifestyle recommendations only, as the control group) were included. The ES group showed significant differences in terms of changes to QoL (mean difference [MD]: 7.41, 95% confidence interval [CI]: 7.90−12.92, p = 0.008), episodes of incontinence (MD: −1.33, 95% CI: −2.50 to −0.17, p = 0.02), and the number of participants cured or improved (risk ratio [RR]: 1.46, 95% CI: 1.14−1.87, p = 0.003), while the biofeedback group resulted in nonsignificant changes in QoL (MD: 0.13, 95% CI: 7.87−8.12, p = 0.98), episodes of incontinence (MD: 0.01, 95% CI: −0.89 to 0.90, p = 0.99), and the number of participants cured or improved (RR: 1.15, 95% CI: 0.99−1.33, p = 0.08), both compared to the control group respectively. Conclusion This meta‐analysis shows that low‐frequency pelvic ES appears to be sufficient and effective as an additional intervention for women with OAB in clinical practice according to improvements in the subjects' QoL and reduction of symptoms. Meanwhile, biofeedback‐assisted PFMT does not appear to be a significant adjuvant for conservative OAB therapy.

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“…Although SUI is not immediately life-threatening, it has a serious impact on patients' quality of life and sex life. Research shows that 19-50% of SUI patients also experience/present with sexual dysfunction, which is a much higher rate than that of women with normal urinary control (3).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of optimized pelvic floor training of YUN combined with pelvic floor magnetic stimulation on female moderate stress urinary incontinence and sexual function: a retrospective cohort study

Wang

Shi

Zhou³

et al. 2022

Transl Androl Urol

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Background: Owing to its tediousness and monotony, traditional pelvic floor muscle training (PFMT) is difficult to ensure the correctness of exercise, and it is difficult for patients to adhere to treatment. We designed this study to evaluate and analyze the efficacy of optimized pelvic floor training of YUN combined with pelvic floor magnetic stimulation on female moderate stress urinary incontinence (SUI) and sexual function.Methods: This is a retrospective cohort study. This study was carried out in 95 female patients with moderate SUI. The inclusion criteria were as follows: premenopausal women aged 25-45; moderate SUI; over 3 months of disease duration; informed consent and cooperation with treatment and follow-up. The participants in group 1 (control group, n=46) were treated with pelvic floor magnetic stimulation, while those in group 2 (trial group, n=49) were treated with pelvic floor magnetic stimulation combined with optimized pelvic floor training of YUN. Evaluations were scheduled before the treatment (0 week), after 6 weeks of treatment (6 weeks), and after 12 weeks of treatment (12 weeks). And compare the differences between the two groups.Results: There was no significant difference in age, body mass index (BMI), duration of disease, and abdominal leak point pressure (ALPP) between the two groups (P>0.05). The total effective rate of the trial group was higher than that of the control group (89.80%, 44/49 vs. 78.26%, 36/46) (P<0.05). The electromyographic values, the International Consultation on Incontinence Questionnaire Short Form (ICI-Q-SF) score, Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire-12 (PISQ-12) score, physiological factors, and emotional factors were all improved significantly in both groups after active treatment, and the improvement of the trial group was more obvious (P<0.05). Conclusions: Optimized pelvic floor training of YUN combined with pelvic floor magnetic are more effective for the treatment of female moderate SUI and sexual function. It has become a safe, effective, and well tolerated new type of pelvic floor functional reconstruction training method with good patient compliance.

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Electromyographic Biofeedback for Stress Urinary Incontinence or Pelvic Floor Dysfunction in Women: A Systematic Review and Meta-Analysis

Cited by 39 publications

References 24 publications

The influence of one-time biofeedback electromyography session on the firing order in the pelvic floor muscle contraction in pregnant woman–A randomized controlled trial

The influence of one-time biofeedback electromyography session on the firing order in the pelvic floor muscle contraction in pregnant woman–A randomized controlled trial

Biofeedback‐assisted pelvic floor muscle training and pelvic electrical stimulation in women with overactive bladder: A systematic review and meta‐analysis of randomized controlled trials

Efficacy of optimized pelvic floor training of YUN combined with pelvic floor magnetic stimulation on female moderate stress urinary incontinence and sexual function: a retrospective cohort study

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