Efficacy of biofeedback on quality of life in stages I and II pelvic organ prolapse: A Pilot study

Ahadi, Tannaz; Taghvadoost, Neda; Aminimoghaddam, Soheila; Forogh, Bijan; Bazaz-Behbahani, Roxana; Raissi, Gholam Reza

doi:10.1016/j.ejogrb.2017.06.023

Cited by 7 publications

(16 citation statements)

References 13 publications

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“…Of the 3918 studies identified by the initial literature searches, 3891 were excluded and 26 RCTs published in English were included. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 The reasons for exclusion and the corresponding references are reported in the online supplementary file (Supplementary File 2 ). A complete overview of the study selection process is provided in the PRISMA flow diagram (Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: A systematic review

Giagio

Innocenti

Salvioli

et al. 2021

Neurourology and Urodynamics

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This systematic review aimed to assess the completeness of exercise reporting in randomized controlled trials (RCTs) on pelvic floor muscle training (PFMT) for women with pelvic organ prolapse (POP). Methods: MEDLINE, Cochrane Central, CINHAL, Embase, SCOPUS, and PEDro databases were searched up to October 2020. Full-text RCTs comparing PFMT to any type of intervention among women with any type and stage of POP were eligible for inclusion. Completeness of intervention was evaluated with t20he template for intervention description and replication (TIDieR) and the consensus on exercise reporting template (CERT). Inter-rater agreement for each item of the tools was calculated. Results: Twenty-six RCTs were included. None of the studies completely reported all intervention descriptors. On average 57.1% (6.8 ± 2.4; out of 12) of the overall TIDieR items and 35.3% (6.7 ± 2.9; out of 19) of the CERT were well described. In particular, 7 and 5 items were completely reported more than 50% of the time for the TIDieR and CERT, respectively. Frequent shortcomings were the undetailed reporting of information regarding tailoring and modifications of exercises and their adherence. Detailed descriptions of exercise repetitions to enable replication were missing in 53.8%. According to the CERT, only 11.5% of the RCTs sufficiently described the main providers' characteristics. Conclusion:The completeness of PFMT reporting for women with POP is still below desirable standards and it is insufficient to ensure transferability into practice. The present results may add relevant knowledge and contribute to improving adequate reporting of exercise.This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Section: Resultsmentioning

confidence: 99%

Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: A systematic review

Giagio

Innocenti

Salvioli

et al. 2021

Neurourology and Urodynamics

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“…These have been characterised by small sample sizes and short-term follow-up. Four trials [80][81][82][83] were not directly comparable to the OPAL trial. Ibrahim et al 80 carried out a randomised comparison of manometric biofeedback-assisted PFMT with PFMT alone in a mixed group of 52 women with either SUI (n = 26) or faecal incontinence, with or without prolapse (n = 26).…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

“…At 12 weeks, more women in the biofeedback PFMT group improved their symptoms than in the PFMT alone group. Ahadi et al 81 carried out a randomised pilot trial of PFMT compared with PFMT plus biofeedback in 40 women with prolapse, with short-term outcomes suggestive of better quality of life in the biofeedback PFMT group at 12 weeks. Liu et al 82 carried out a comparison of biofeedback plus electrical stimulation compared with conventional PFMT and no treatment in perimenopausal SUI.…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

Basic versus biofeedback-mediated intensive pelvic floor muscle training for women with urinary incontinence: the OPAL RCT

Hagen

Bugge

Dean

et al. 2020

Health Technol Assess

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Background Urinary incontinence affects one in three women worldwide. Pelvic floor muscle training is an effective treatment. Electromyography biofeedback (providing visual or auditory feedback of internal muscle movement) is an adjunct that may improve outcomes. Objectives To determine the clinical effectiveness and cost-effectiveness of biofeedback-mediated intensive pelvic floor muscle training (biofeedback pelvic floor muscle training) compared with basic pelvic floor muscle training for treating female stress urinary incontinence or mixed urinary incontinence. Design A multicentre, parallel-group randomised controlled trial of the clinical effectiveness and cost-effectiveness of biofeedback pelvic floor muscle training compared with basic pelvic floor muscle training, with a mixed-methods process evaluation and a longitudinal qualitative case study. Group allocation was by web-based application, with minimisation by urinary incontinence type, centre, age and baseline urinary incontinence severity. Participants, therapy providers and researchers were not blinded to group allocation. Six-month pelvic floor muscle assessments were conducted by a blinded assessor. Setting This trial was set in UK community and outpatient care settings. Participants Women aged ≥ 18 years, with new stress urinary incontinence or mixed urinary incontinence. The following women were excluded: those with urgency urinary incontinence alone, those who had received formal instruction in pelvic floor muscle training in the previous year, those unable to contract their pelvic floor muscles, those pregnant or < 6 months postnatal, those with prolapse greater than stage II, those currently having treatment for pelvic cancer, those with cognitive impairment affecting capacity to give informed consent, those with neurological disease, those with a known nickel allergy or sensitivity and those currently participating in other research relating to their urinary incontinence. Interventions Both groups were offered six appointments over 16 weeks to receive biofeedback pelvic floor muscle training or basic pelvic floor muscle training. Home biofeedback units were provided to the biofeedback pelvic floor muscle training group. Behaviour change techniques were built in to both interventions. Main outcome measures The primary outcome was urinary incontinence severity at 24 months (measured using the International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form score, range 0–21, with a higher score indicating greater severity). The secondary outcomes were urinary incontinence cure/improvement, other urinary and pelvic floor symptoms, urinary incontinence-specific quality of life, self-efficacy for pelvic floor muscle training, global impression of improvement in urinary incontinence, adherence to the exercise, uptake of other urinary incontinence treatment and pelvic floor muscle function. The primary health economic outcome was incremental cost per quality-adjusted-life-year gained at 24 months. Results A total of 300 participants were randomised per group. The primary analysis included 225 and 235 participants (biofeedback and basic pelvic floor muscle training, respectively). The mean 24-month International Consultation on Incontinence Questionnaire Urinary Incontinence Short Form score was 8.2 (standard deviation 5.1) for biofeedback pelvic floor muscle training and 8.5 (standard deviation 4.9) for basic pelvic floor muscle training (adjusted mean difference –0.09, 95% confidence interval –0.92 to 0.75; p = 0.84). A total of 48 participants had a non-serious adverse event (34 in the biofeedback pelvic floor muscle training group and 14 in the basic pelvic floor muscle training group), of whom 23 (21 in the biofeedback pelvic floor muscle training group and 2 in the basic pelvic floor muscle training group) had an event related/possibly related to the interventions. In addition, there were eight serious adverse events (six in the biofeedback pelvic floor muscle training group and two in the basic pelvic floor muscle training group), all unrelated to the interventions. At 24 months, biofeedback pelvic floor muscle training was not significantly more expensive than basic pelvic floor muscle training, but neither was it associated with significantly more quality-adjusted life-years. The probability that biofeedback pelvic floor muscle training would be cost-effective was 48% at a £20,000 willingness to pay for a quality-adjusted life-year threshold. The process evaluation confirmed that the biofeedback pelvic floor muscle training group received an intensified intervention and both groups received basic pelvic floor muscle training core components. Women were positive about both interventions, adherence to both interventions was similar and both interventions were facilitated by desire to improve their urinary incontinence and hindered by lack of time. Limitations Women unable to contract their muscles were excluded, as biofeedback is recommended for these women. Conclusions There was no evidence of a difference between biofeedback pelvic floor muscle training and basic pelvic floor muscle training. Future work Research should investigate other ways to intensify pelvic floor muscle training to improve continence outcomes. Trial registration Current Controlled Trial ISRCTN57746448. Funding This project was funded by the NIHR Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 70. See the NIHR Journals Library website for further project information.

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“…Hagen et al's (2017) findings although not significant showed how the effects of POP interfered with everyday life, personal hygiene, physical and social activity had improved through receiving conservative treatment of PFMT through physiotherapist appointments, information on PFMT, Pilates classes, exercise DVD and prolapse lifestyle advice leaflet. Ahadi et al (2017) report the most significant improvements in the QOL of participants who had completed integrated treatments consisting of home PFMT exercises, lifestyle advice and biofeedback as opposed to just receiving home pelvic floor exercises and a lifestyle advice leaflet. Prolapse impact, physical and role limitations significantly improved in the intervention group that received physiotherapy sessions, information about pelvic floor muscle treatment and lifestyle advice in Ouchi et al (2018) and Ahadi et al's (2017) study.…”

Section: Study Characteristicsmentioning

confidence: 94%

“…All seven papers included in this systematic literature review are quantitative studies (Ouchi et al, 2017(Ouchi et al, , 2018Hagen et al, 2014Hagen et al, , 2017Ahadi et al, 2017;Due et al, 2016;Kashyap et al, 2013). The results of these papers have been reported narratively as no meta-analysis was possible.…”

Section: Study Characteristicsmentioning

confidence: 99%

Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

Davies

Burdett

2020

JICA

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PurposeIntegrated healthcare is a central tenant of the NHS Long Term Plan (NHS, 2019). NICE in 2019 published guidelines; advising the integration of multidisciplinary professionals which may lead to an improvement in conservative treatment methods of pelvic organ prolapse. Therefore, current literature on the conservative treatments for pelvic organ prolapse needs to be reviewed to ascertain if an integrated approach would improve the symptoms and quality of life for women.Design/methodology/approachA systematic review of the literature between 2013 and 2018 was implemented. Papers included were written in English, peer-reviewed and consisted of treatments of pelvic organ prolapse in women. Papers containing surgical interventions, postpartum participants, reviews, evaluations, guidelines, follow-up studies, focusing on cost effectiveness, sexual function were excluded.FindingsSeven studies in total were included, and two overarching themes were identified: quality of life after treatment and the effect of conservative treatment on pelvic organ prolapse symptoms. The literature suggested that integrating care had a more positive outcome on pelvic organ symptoms and quality of life.Research limitations/implicationsTo develop a robust enhanced model of care for conservative treatment of pelvic organ prolapse through more mixed method or qualitative research, that incorporates integrative treatment methods with collaboration from multidisciplinary professionals.Practical implicationsThe practical implications of integrating the conservative management of pelvic organ prolapse is the communication between the multidisciplinary team must be exceptional to ensure everyone understands and agrees the treatment that is being provided to patient. Also, effective teamwork is important to ensure the patient receives the best care with input from the correct disciplines. The multi-professional team will need to have regular meetings to discuss and implement care plans for patients that might prove difficult to schedule due to differing commitments and priorities. This must be overcome to insure a successful and effective integrated approach to pelvic organ prolapse is delivered.Social implicationsThe social implications of integrating the professional approach to women's care of pelvic organ prolapse involves reducing the severity of the symptoms therefore, increasing the quality of life. This may result in the reduction of surgical intervention due to the patient being satisfied with the conservative management. Through integrating the management of the prolapse the patient will receive an accessible individualised care plan pathway that focuses on treating or reducing the impact of the symptoms that are bothersome to the patient whilst managing patient expectations. Patients will also, be reassured by the number of multi-disciplinary professionals involved in their care.Originality/valueGlobal integration of conservative treatments and multidisciplinary-professionals specialising in pelvic organ prolapse and pelvic floor dysfunction is needed.

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Efficacy of biofeedback on quality of life in stages I and II pelvic organ prolapse: A Pilot study

Cited by 7 publications

References 13 publications

Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: A systematic review

Completeness of exercise reporting among randomized controlled trials on pelvic floor muscle training for women with pelvic organ prolapse: A systematic review

Basic versus biofeedback-mediated intensive pelvic floor muscle training for women with urinary incontinence: the OPAL RCT

Would integrating women's professional care of pelvic organ prolapse improve the symptoms and quality of life: an integrative literature review

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