Pelvic Floor Dysfunction Clinical Trial
Official title:
Efficacy of Pelvic Floor Muscle Training Using Bio-assisted Surface Electromyography in Women With Pelvic Floor Dysfunction With and Without Pelvic Organ Prolapse
Recent studies have found that pelvic floor muscle training can relieve pelvic organ prolapse related symptoms. However, the rate of cure or improvement of symptoms with exercise prescription, different compliance of the patient's behavior have great differences. Biofeedback is an instrument used to record the biological signals ( electrical activity) during a voluntary pelvic floor muscle contraction and provide feedback in auditory or visual form (a louder sound with a stronger squeeze or an increasing number of lights on a visual display as the strength of the squeeze increased). Therefore, this study would explore the efficacy of biofeedback-assisted pelvic floor muscle training in women with pelvic floor dysfunction with or without organ prolapse.
Treatment options for pelvic floor dysfunction (PFD) vary depending on symptom severity.
Conservative approaches such as pelvic floor muscle (PFM) exercises, biofeedback, and
lifestyle advice are usually suggested for urgency incontinence (UI), overactive bladder
(OAB), and mild-to-moderate pelvic organ prolapse (POP). Conservative management remains the
gold standard of treatment for female UI and OAB. There is Level 1, Grade A evidence
supporting pelvic floor muscle training (PFMT) as an effective treatment for UI and OAB, and
Grade B evidence that pelvic floor muscle training (PFMT) reduces the symptoms of urogenital
prolapse, although topographic changes are not expected. Most of the past literatures focused
on the effectiveness of PFMT on single disease, but seldom explored its effectiveness on
complex disease (i.e. women presenting with more than one type of PFD). In the real world,
some degree of POP was present in 41% to 50% of women on physical examination, but only 3% of
patients reported symptoms such as bearing down sensation of vagina. Besides, there was a
number of studies that assessed the efficacy of PFMT as a treatment for women with POP, but
rarely explored its effectiveness in both subjective and objective (anatomic) improvement of
prolapse severity.
Biofeedback provides positive reinforcement to patients performing PFMT, therefore improves
the quality of life of women with PFD. It can be achieved via several methods, including
electromyography (EMG), manometry, or ultrasonography. A systematic review confirmed the
benefit of adding of biofeedback to PFMT, but it was not clear whether this was the effect
was related to another variable, such as the amount of health professional contact rather
than the biofeedback.
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