Pelvic floor muscle training (PFMT) is commonly used as the initial treatment for stress urinary incontinence (SUI), with the aim of improving muscle volume, closing the elevator hiatus, reducing muscle length, and raising the resting position of the bladder and rectum. To determine whether the incorporation of biofeedback (BF) into PFMT could enhance the adherence to home exercises among women with SUI, a randomized controlled trial was conducted. The trial was rated 6 out of 10 on the PEDro scale for methodological quality. Seventy-two women suffering from incontinence were randomly assigned to either the BF group (consisting of outpatient BF sessions combined with home PFMT) or the PFMT group (comprising outpatient PFMT sessions and home PFMT). Evaluations were carried out at the beginning, after three months of supervised treatment, and at a nine-month follow-up (following an additional six months of home PFMT only). The primary outcome measure was the frequency of monthly exercise sets performed, as recorded in an exercise diary, after the initial three-month treatment period. Secondary outcomes encompassed adherence to the treatment, urinary symptoms, severity and resolution of SUI, muscle function, quality of life, and patient satisfaction with the treatment. The findings revealed that both the BF group (67.9 out of 82) and the PFMT group (68.2 out of 82) performed a similar number of monthly home exercise sets after three months. Regarding secondary outcomes, both groups reported comparable levels of satisfaction, but the BF group exhibited a significantly higher rate of objective cure for SUI following the three-month treatment. By the time of the nine-month follow-up, both groups showed comparable adherence rates to home exercises, which were around 50%. These rates were significantly lower compared to the adherence observed at the three-month assessment, which was approximately 85%. Additionally, there were no notable differences between the two groups regarding the objective and subjective rates of cure for SUI after the nine-month period. Both therapies exhibited similar enhancements in muscle function and quality of life throughout the study. In summary, the utilization of biofeedback did not result in an increase in the frequency of home exercises carried out by women with SUI.

David Lucena Atón

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