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==Randomized controlled trial of pelvic floor muscle training with or without biofeedback for urinary incontinence ==

Program in Physical and Occupational Therapy, Nagoya University Graduate School of Medicine, 1-1-20, Daiko-minami, Higashi-ku, Nagoya, 461-8673, Japan.

INTRODUCTION AND HYPOTHESIS
To compare the effects of pelvic floor muscle training (PFMT), with or without biofeedback (BF), for stress urinary incontinence (SUI), focusing on condition-specific quality of life (QOL) outcomes.

METHODS
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' exercise training.

RESULTS
Of the 9 domains of the KHQ, the scores of 5 significantly decreased in the PFMT group, and 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 (P = 0.054). 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.

CONCLUSIONS
The results indicate that PFMT is effective for treating SUI. There is no apparent add-on effect of BF training in short-term follow-up.

To do

 * pelvic floor muscle training:
 * report research result: '''Pelvic floor muscle training may be accompanied with biofeedback treatment, however a study found no benefit of adding it to PFMT in stress urinary incontinence.
 * Maximum vaginal squeeze pressure
 * biofeedback:
 * report research result: Contradicting this, a 2013 randomized controlled trial found no benefit of adding biofeedback to pelvic floor muscle exercise in stress urinary incontinence. 
 * stress urinary incontinence:
 * include Pelvic_floor_muscle_training w or wo BF A 2013 randomized controlled trial found no benefit of adding biofeedback to pelvic floor muscle exercise in stress urinary incontinence, but observing improvements in both groups. 
 * quantification
 * voiding diary
 * 1-h pad test, leakage volume
 * measurement of PFM strength
 * number of incontinence episodes
 * Maximum vaginal squeeze pressure
 * QoL:
 * create section: condition-specific quality of life
 * King's Health Questionnaire (KHQ)
 * International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF)