USING VISUAL BIOFEEDBACK AS A METHOD TO ENHANCE THE SELF-EFFICACY OF PELVIC FLOOR MUSCLE TRAINING IN WOMEN WITH STRESS INCONTINENCE: A QUANTITATIVE STUDY.

Abstract

Background and Purpose: Urinary incontinence is most effectively treated with frequent physiotherapist supervised pelvic floor muscle training. Although self-management provides a more sustainable and accessible treatment alternative, effective home-based PFMT is limited by poor adherence, improper technique and limited feedback. This project proposes using the Neen Educator, a biofeedback device, as a learning tool to enhance PFMT selfefficacy in order to support home-based training effectiveness, improve quality of life and promote adherence during the early stages of adopting a new exercise. Method: This quantitative experimental study randomly assigned 9 participants to one of two intervention groups: Control (n=4) or BF (n=5). Both groups attended individual initial interventions which included education about PF anatomy, proper PFMT technique and an optional pelvic floor assessment. All participants were asked to complete 4 weeks of regular PFMT (3x per day). The BF group was also provided with the Neen Educator BF device to assist PFMT during the first 2 weeks. Participants were asked to complete the Broome PMSES and ICIQ-SF questionnaires at baseline, after 2 and 4 weeks. Adherence was also measured through bladder diaries. Results: Statistical analysis revealed that there was no statistically significant difference between control and BF groups in SE, QoL or adherence after 2 or 4 weeks of PFMT. All participants, irrespective of group, achieved statistically significant improvements in the Broome PMSES and ICIQ-SF at 2 and 4 weeks of PFMT however there was no statistically significant correlation found between SE and QoL. Conclusion: The results of this study showed that thorough education and regular PFMT over the course of 4-weeks improved pelvic floor muscle self-efficacy and incontinence specific quality of life in women with stress UI and mixed UI. Using the Neen Educator in conjunction with PFMT did not improve SE, QoL or adherence more so than conventional PFMT. The BF group did achieve greater mean SE scores, after 2-weeks of PFMT than the control group. Although not significantly different, this improvement suggests that a homebased BF device such as the Neen Educator may improve confidence in proper PFMT technique during the early stages of learning.