Biofeedback for the treatment of female pelvic floor muscle dysfunction: a systematic review and meta-analysis

dc.contributor.authorFitz, Fatima Fani [UNIFESP]
dc.contributor.authorMagalhaes Resende, Ana Paula [UNIFESP]
dc.contributor.authorStuepp, Liliana [UNIFESP]
dc.contributor.authorFerreira Sartori, Marair Gracio [UNIFESP]
dc.contributor.authorBatista Castello Girao, Manoel Joao [UNIFESP]
dc.contributor.authorCastro, Rodrigo Aquino [UNIFESP]
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.description.abstractBiofeedback (BF) has been widely used in the treatment of pelvic floor dysfunctions, mainly by promoting patient learning about muscle contraction with no side effects. However, its effectiveness remains poorly understood with some studies suggesting that BF offers no advantage over the isolated pelvic floor muscle training (PFMT). the main objective of this study was to systematically review available randomized controlled trials assessing the effectiveness of BF in female pelvic floor dysfunction treatment. Trials were electronically searched and rated for quality by use of the PEDro scale (values of 0-10). Randomized controlled trials assessing the training of pelvic floor muscle (PFM) using BF in women with PFM dysfunction were selected. Outcomes were converted to a scale ranging from 0 to 100. Trials were pooled with software used to prepare and update Cochrane reviews. Results are presented as weighted mean differences with 95 % confidence intervals (CI). Twenty-two trials with 1,469 patients that analyzed BF in the treatment of urinary, anorectal, and/or sexual dysfunctions were included. PFMT alone led to a superior but not significant difference in the function of PFM when compared to PFMT with BF, by using vaginal measurement in the short and intermediate term: 9.89 (95 % CI -5.05 to 24.83) and 15.03 (95 % CI -9.71 to 39.78), respectively. We found a few and nonhomogeneous studies addressing anorectal and sexual function, which do not provide the cure rate calculations. Limitations of this review are the low quality and heterogeneity of the studies, involving the usage of distinct protocols of interventions, and various and different outcome measures. the results of this systematic review suggest that PFMT with BF is not more effective than other conservative treatments for female PFM dysfunction.en
dc.description.affiliationUniversidade Federal de São Paulo, Dept Gynecol, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Gynecol, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipConselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
dc.description.sponsorshipIDCNPq: 153287/2010-1
dc.identifier.citationInternational Urogynecology Journal. London: Springer London Ltd, v. 23, n. 11, p. 1495-1516, 2012.
dc.relation.ispartofInternational Urogynecology Journal
dc.rightsAcesso restrito
dc.subjectPelvic floor muscleen
dc.subjectUrinary incontinenceen
dc.subjectFecal incontinenceen
dc.subjectSexual dysfunctionen
dc.titleBiofeedback for the treatment of female pelvic floor muscle dysfunction: a systematic review and meta-analysisen