ICS 2018: Biofeedback Assisted Pelvic Floor Muscle Training in Adults and Children-Case Presentations

Philadelphia, PA (UroToday.com) The purpose of this presentation was to introduce biofeedback as an effective option for the treatment of lower urinary tract symptoms. According to the presenters, urinary incontinence (UI) is prevalent in 20 - 45% of community-dwelling adults, 75% of nursing home residents, and 5-7 million of children ages 6 and older. In addition, UI management is associated with high healthcare costs. Therefore, it is important to approach UI treatment through a comprehensive assessment of symptoms, accurate diagnosis, and elimination of reversible causes (thin, dry vaginal and urethral epithelium, stool impaction/constipation, infection, limited mobility, emotional issues, therapeutic medications, endocrine disorders, and delirium).

Pelvic muscle rehabilitation is a recognized conservative practice, which is proven to reduce urge urinary incontinence, stress urinary incontinence, and pelvic floor prolapse. Biofeedback-assisted pelvic floor muscle training allows for the audio and video feedback of patient’s pelvic exercises. Usually, it consists of 2 active electrodes and 1 reference electrodes, which are placed on pelvic floor muscles and accessory muscles (abdominals, gluts or adductors). Wires transmit signals to the recording device, thus allowing assessment of pelvic floor contractions. Biofeedback training usually prescribed due to decreased strength, increased tone, decreased body awareness, decreased proprioception, and poor coordination of pelvic floor muscle (PFM). Quick flick performance is reflected in Figure 1. Figure 2 demonstrates incorrect exercise techniques.

UroToday ICS2018 Biofeedback Assisted Pelvic Floor Muscle Training graph
Figure 1
UroToday ICS2018 Biofeedback Assisted Pelvic Floor Muscle Training graph 2
Figure 2

Interpretation of the recording includes analysis of resting baseline (should stay low), ability to recruit and deactivate PFM upon command, the speed of return to baseline after contraction, ability to isolate PFM from accessory muscles, ability to repeat PFM contractions, and amplitude of the contraction for each task.

Two case studies were presented to demonstrate real-world biofeedback application. According to the presenters, PFM training is an effective tool to teach muscle exercises and potentially improve patient’s urinary control and muscle strength.


Presented by: Andrea R. Branas, PT, DPT, MSE, Children’s Hospital of Philadelphia
Co-Authors: Donna L. Thompson, MSN, CRNP, FNP-BC, CCCN-AP, University of Pennsylvania

Written by: Hanna Stambakio, BS, Clinical Research Coordinator, Division of Urology, University of Pennsylvania, @PennUrology at the 2018 ICS International Continence Society Meeting - August 28 - 31, 2018 – Philadelphia, PA USA
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