Efficacy of pelvic floor training with surface electromyography feedback for female stress urinary incontinence

• Published in: International journal of nursing practice 2018-12, Vol.24 (6), p.e12698-n/a
• Main Authors: Liu, Ying‐Ju, Wu, Wen‐Yih, Hsiao, Sheng‐Mou, Ting, Stella Wan‐Hua, Hsu, Hsiao‐Pei, Huang, Chiu‐Mieh
• Format: Article
• Language: English
• Subjects: Adult; Aged; bio‐assisted surface electromyographic program; Body mass index; Clinical trials; Efficacy; Electromyography; Evidence-based nursing; Exercise Therapy; Feedback; Female; Health care; Humans; Middle Aged; Muscle Contraction; Muscles; Neurofeedback; Nursing; Pelvic Floor; pelvic floor muscle training; Physical therapy; Positive reinforcement; Prospective Studies; Reinforcement; Stress; stress urinary incontinence; Urinary incontinence; Urinary Incontinence, Stress - therapy; Women; Womens health
• ISSN: 1322-7114; 1440-172X
• DOI: 10.1111/ijn.12698

Aims The aim of the study is to compare the efficacy of an 8‐week pelvic floor muscle training program with surface electromyography feedback, performed in different body positions (supine, sitting, and standing), in women with stress urinary incontinence. Design This is a prospective observational study performed January 2014 to May 2016. Methods The training program was performed by 110 women with stress urinary incontinence, each completing 4 individual training sessions. The main outcome was the electromyography activity of the pelvic floor muscles and of the synergistic abdominal muscles. Outcome measures were evaluated at 4 time points, namely at baseline and at 2, 4, and 8 weeks of training. Results A notable effect of training was identified at week 2, which was sustained through to week 8. Training yielded a significant improvement in increased sustained voluntary contraction of the pelvic floor muscles in all 3 positions. The efficacy of training was influenced by the duration of training, age, body mass index, and history of vaginal delivery. Conclusion Training of the pelvic floor muscles, with positive reinforcement by surface electromyography feedback of the pelvic floor muscles and of the synergistic abdominal muscles, was effective for the treatment of stress urinary incontinence in women and should be considered as a feasible option by healthcare providers. SUMMARY STATEMENT What is already known about this topic? In women with stress urinary incontinence, the sudden loss of urine negatively affects their quality of life. Conservative treatment remains the mainstay for managing this condition, for which pelvic floor muscle training is regarded an effective treatment. Biofeedback provides positive reinforcement during pelvic floor muscle training and can be achieved via several methods including electromyography, manometry, or ultrasonography. What this paper adds? An 8‐week training program, using surface electromyography as feedback, was effective in reducing female stress urinary incontinence; the effect was notable after 2, 4, and 8 weeks of training. The program was effective when performed in supine, standing, and sitting positions, with the greatest improvement obtained in the supine position. The duration of training, age, body mass index, and history of vaginal delivery were significant factors influencing training outcome. The implications of this paper: Health care professions should be adept at evaluating the severity of stress