Thursday, January 24, 2013

New in the Literature: PFMT for Urinary Incontinence (Int Urogynecol J. 2013 Jan 11. [Epub ahead of print])

Pelvic floor muscle training (PFMT) is effective for treating stress urinary incontinence (SUI), say authors of an article published in International Urogynecology Journal. There is no apparent add-on effect of biofeedback (BF) training in short-term follow-up, they add.

Women with SUI were randomized to PFMT with BF (BF group, n = 23) or without BF (PFMT group, n = 23) for 12 weeks. As primary outcome measures, subjective symptoms and QOL were assessed by the King's Health Questionnaire (KHQ) and International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). A voiding diary, 1-h pad test, and measurement of PFM strength were secondary outcome measures. Changes in the primary and secondary outcomes were assessed before and after 12 weeks of exercise training.

Of the 9 domains of the KHQ, the scores of 5 significantly decreased in the PFMT group; the scores of 7 significantly decreased in the BF group. All ICIQ-SF items and the total score significantly decreased in both groups after therapy. The number of incontinence episodes significantly decreased in the PFMT group, and tended to decrease in the BF group, but this was not significant. The leakage volume in the 1-h pad test tended to decrease in both groups, but was not significant. Maximum vaginal squeeze pressure significantly increased in both groups. There were no significant inter-group differences in the changes in any of the parameters assessed.

Comments

I do not find this article to be of ANY value. The size of the study alone does not lend to any relevance ( n=23 in both groups ). Furthermore, I will tell you as a therapist devoted to pelvic floor therapy 100% of the time, the use of biofeedback is invaluable. 85% of females (through the decades) are unable to isolate the PF muscles, and 60% of the male population I have treated are also unable to isolate the PF muscles. We would ALL agree that in order to be able to strengthen a muscle we must first be able to contract the muscle. Patients who have weakness and decreased proprioception will be hard pressed to isolate the correct muscle group. Biofeedback with a visual representation hsa been proven to enhance a patients proprioception and ability to isolate the PF muscles. So, before we go passing out information on small studies like this that could affect our ability to do what we know to be best-demonstrated clinical practice and could affect our ability to be reimbursed by insurance, it behooves us to look at these studies with close scrutiny. What you need to be printing in your publication are articles and valid research that SUPPORT what we do, not question it!

Posted by Mitzi Gibson, MSPT on 1/26/2013 5:37 PM
There's a new and safer way to achieve the same results as Coaptite. Using blood-derived growth factors to treat stress incontinence avoids the risk of granuloma formation. You can find out more by going to the following website: http://OShot.info/members/stress

Posted by Charles Runels on 9/6/2013 1:33 AM

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