Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women: shortened version of a Cochrane systematic review

Roselien Herderschee, E C Jean Hay-Smith, G Peter Herbison, Jan Paul Roovers, Maas Jan Heineman
Neurourology and Urodynamics 2013, 32 (4): 325-9

BACKGROUND: Feedback and biofeedback (BF) are common adjuncts to pelvic floor muscle training (PFMT) for women with stress, urgency, and mixed urinary incontinence (UI). An up to date systematic review of adjunctive feedback or BF was needed to guide practice and further research.

OBJECTIVES: To determine whether feedback or BF add benefit to PFMT for women with UI.

METHODS: The Cochrane Incontinence Group Specialised Trials Register was searched (May 2010) for randomised or quasi-randomized trials in women with stress, urgency or mixed UI regardless of cause, which compared PFMT versus PFMT augmented with feedback or BF. Two reviewers independently undertook eligibility screening, risk of bias assessment and data extraction. Analysis was in accordance with the Cochrane Handbook for Systematic Reviews of Intervention (version 5.0.2).

RESULTS: Twenty-four trials were included, and many were at moderate to high risk of bias. Women who received BF were less likely to report they were not improved (RR 0.75, 95% CI: 0.66-0.86), although there was no statistically significant difference for cure (RR 0.92, 95% CI: 0.81-1.05) and marginal statistical significance for leakage episodes (mean difference: -0.12 leaks/day, 95% CI: -0.22 to -0.01). It is possible the results are confounded because women in the BF group commonly had more contact with the health professional than those in the PFMT only arm.

CONCLUSION: BF may add benefit to PFMT but the observed effect could well be related to another variable, such as the amount of health professional contact rather than the BF per se.

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