Does biofeedback work?

This study investigated the addition of training feedback, or biofeedback, to pelvic floor muscle training.

Pelvic floor muscle training is an effective treatment for stress urinary incontinence (and some evidence suggests for all types of urine incontinence). In pelvic floor muscle exercises, the pelvic floor muscles are squeezed and lifted, and then relaxed, several times in a row. These exercises help strengthen the muscles, improve their endurance, and improve muscle coordination (so the muscle squeezes hardest when the risk of leaking is greatest, for example while coughing or sneezing). Contracting the right muscles, at the right time, is important for treatment success.

Feedback or biofeedback are ways to teach patients how to contract the correct muscles, when to contract the muscle to prevent leakage, and to assess whether muscle contraction is improving over time. In essence, feedback or biofeedback are used as 'trainers' for repetitive exercising.

One method of biofeedback, for example, uses a vaginal or anal device to measure muscle activity or squeeze pressure. The device then sends this information back to the patient, who can use the information to improve training.

The current analysis examined the benefits of different types of biofeedback with pelvic floor muscle training. Twenty-four trials, including a total of 1583 women, were reviewed in this analysis.

Overall, women who received biofeedback during pelvic floor muscle training were more likely to report improved quality of life. Women receiving biofeedback were also more likely to report that their urinary incontinence had improved compared to those receiving pelvic muscle training alone. However, feedback was not beneficial in all the trials reviewed. Results and method of feedback used varied widely between the different trials.

This analysis concluded that there was some evidence that adding biofeedback to pelvic floor muscle exercise is beneficial in treating urinary incontinence. 

Women receiving feedback spent on average significantly more time with a healthcare provider. It is unclear whether reported benefit came from feedback itself, or from spending more time in clinic with the doctor, nurse or physiotherapist.