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.