Biofeedback

Biofeedback has been defined as “a group of experimental procedures where an external sensor is used to give an indication on bodily processes, usually for the purpose of changing the measured quality.” Pelvic floor muscle training (PFMT) can be conducted with and without biofeedback. The aim of this chapter is to give an overview of randomized controlled trials (RCTs) comparing the results of PFMT with and without biofeedback on stress and mixed incontinence. A Cochrane review found 24 RCTs. Women who received biofeedback were significantly more likely to report that UI was cured or improved compared to those who received PFMT alone (risk ratio 0.75, 95% confidence interval 0.66–0.86). However, women in the biofeedback arms usually had more contact with the health professional than those in the non-biofeedback arms, many trials were at moderate to high risk of bias, and sample sizes of the groups were generally small. Studies comparing the same dosage of training with and without use of biofeedback showed no statistically significant differences. Hence, the International consensus on Continence 2017 concluded that based on the existing evidence from RCTs, PFMT is effective when used alone, and biofeedback is not necessary to achieve efficacy. However, some patients may be motivated to adhere to a training program and work harder using biofeedback. Conclusion: Use of biofeedback has not shown to give additional effect to pelvic floor muscle training. However, if available, interested and cooperative patients should be given the option of using biofeedback to increase motivation and adherence to training.