Stress urinary incontinence in women : the therapeutic benefits of pelvic floor muscle training with and without electromyographic biofeedback

Abstract

Overview of the Topic: Stress urinary incontinence (SUI) is caused from involuntary leakage during increased abdominal pressure. Physiotherapeutic interventions, such as, pelvic floor muscle training (PFMT) can cure or alleviate such symptom. Additionally, electromyographic biofeedback (EMG-BF) may be an addtion to PFMT by providing feedback on the muscle contractions. The Research Question: In women with stress urinary incontinence, does electromyographic biofeedback with pelvic floor muscle training offer greater therapeutic benefits than pelvic floor muscle training alone? PICO Elements: Population: Women with SUI; Intervention: The addition of EMGBF to PFMT; Comparator: PFMT alone; Outcome: The therapeutic benefits on SUI. Inclusion and Exclusion Criteria: It included women with SUI over 18 years of age and studies published in English, between 2011-2021. It excluded pregnant/postnatal women, those with cognitive impairments, neurological diseases, malignancies, urinary tract infections, pelvic organ prolapse greater than II, those that have already done PFMT before and those unable to contract the pelvic floor muscles. Outcome of the Search: The chosen key studies were four randomised controlled trials (RCTs). Appraisal: Appraisal was done using the Critical Appraisal Skills Programme tool for RCTs. Results: Most of the studies found that the addition of EMG-BF to PFMT is not superior to PFMT alone. Despite this, Özlü et al. (2017) and the outcome measures of the PFM strength in Bertotto et al. (2017) found the opposite. Conclusion: It was concluded that the addition of EMG-BF to PFMT does not provide greater therapeutic benefits than PFMT alone. Implications and Recommendations: EMG-BF does not need to be included in the standard routine physiotherapy care of patients with SUI. Further research on the research gaps and limitations is recommended.