Effectiveness of pelvic floor muscle biofeedback electrical stimulation combined with pelvic floor muscle training for mild to moderate postpartum stress urinary incontinence / 中华围产医学杂志

Objective:To analyze the effects of pelvic floor muscle biofeedback electrical stimulation (PEMS) combined with pelvic floor muscle training (PFMT) and PFMT alone on mild to moderate stress urinary incontinence (SUI) after delivery.Methods:This retrospective study involved 1 087 postpartum women with mild or moderate SUI who were admitted to the Affiliated Hospital of Jining Medical University from January 2017 to January 2021. According to the treatment approaches, they were divided into two groups: the PMES+PFMT group ( n=504) and the PFMT group ( n=583). Chi-square test, independent sample t-test and rank sum test were used to compare the objective indicators (pelvic floor muscle strength test, vaginal dynamic pressure value test, 1-h pad test) and subjective indicators [incontinence impact questionnaire short form (IIQ-7), incontinence questionnaire-urinary incontinence short form (ICI-Q-SF), pelvic organ prolapse/urinary incontinence sexual function questionnaire (PISQ-12)] before, immediate and three months after treatment between the two groups. Results:There was no significant difference between the two groups in the values of vaginal dynamic pressure before treatment, 1-h pad test results and subjective indicators (all P>0.05). Comparison within groups: Indicators were improved in both groups immediate and three months after treatment compared with before treatment, including strength of type Ⅰ muscle [PMES+PFMT group: grade 4 and 5 (normal): 43.5% (219/504) and 42.1% (212/504) vs 1.2% (6/504), χ 2=864.27 and 861.46; PFMT group: grade 4 and 5:19.2% (112/583) and 20.1% (117/583) vs 1.5% (9/583), χ 2=1 148.26 and 1 038.29] and class Ⅱ muscle strength [PMES+PFMT group: 48.4% (244/504) and 50.8% (256/504) vs 4.8% (24/504), χ 2=862.96 and 819.24; PFMT group: 37.4% (218/583) and 38.9% (227/583) vs 5.0% (29/583), χ 2=1 029.47 and 998.54; all P < 0.05].Vaginal dynamic pressure increased [PMES+PFMT group: (89.3±5.4) and (82.2±4.6) vs (67.5±12.7) cmH 2O (1 cmH 2O=0.098 kPa), t=802.13 and 845.54; PFMT group:(80.2±4.3) and (78.6±4.5) vs (66.9±14.2) cmH 2O, t=288.37 and 244.94], and 1-hour urine leakage reduced [PMES+PFMT group: 2.0 g (2.0-3.0 g) and 2.0 g (1.0-3.0 g) vs 6.0 g (5.0-6.0 g), Z=825.39 and 802.13; PFMT group: 4.0 g (3.0-5.0 g) and 3.0 g (3.0-4.0 g) vs 5.0 g (4.0-6.0 g), Z=836.34 and 811.25], and IIQ-7 scores [PMES+PFMT group: scores of 3 (2-4) and 4 (3-4) vs 8 (7-9), Z=959.52 and 825.87; PFMT group: 5 (4-5) and 5 (4-6) vs 8 (7-10), Z=916.27 and 903.18], and ICI-Q-SF score [PMES+PFMT group: 3.5 (3-4) and 4 (3-5) vs 10 (9-12), Z=952.79 and 924.94; PFMT group: 6 (4-7) and 6 (5-7) vs 11 (10-12), Z=1 049.89 and 998.15], and PISQ-12 score [PMES+PFMT group: 10 (7-12) and 9 (7-12) vs 21 (17-24), Z=862.55 and 887.17; PFMT group: 13 (11-16) and 14 (12-16) vs 22 (18-25), Z=1 026.73 and 934.86, all P<0.05) decreased. Compared with the PFMT group, the above indexes were all better in the PMES+PFMT group (all P<0.05). Conclusion:PFMT alone or in combination with PMES can both enhance pelvic floor muscle strength, increase vaginal dynamic pressure, alleviate urine leakage and improve the quality of life and PMES+PFMT is better and more effective.

Efeito do biofeedback no coping da equipe de enfermagem: ensaio clínico randomizado / Efecto del biofeedback en el coping del equipo de enfermería: ensayo clínico aleatorizado / Effect of biofeedback on nursing team coping: a randomized clinical trial

Resumo Objetivo Avaliar o efeito do Biofeedback cardiovascular sobre os níveis de coping dos profissionais da enfermagem de um hospital universitário, quando comparado com uma atividade informatizada sem automonitoramento. Métodos Ensaio clínico randomizado, com dois grupos, Biofeedback e placebo, realizado com 115 profissionais de enfermagem de um hospital universitário. Os grupos participaram de nove encontros por três semanas. O desfecho foi avaliado pelo Inventário de Respostas de Coping no Trabalho, versão brasileira, aplicado prévio a primeira sessão e imediatamente após a sessão final. A análise do desfecho foi feita pela ANCOVA , considerando α = 5%. Resultados A variação das Respostas de Enfrentamento apresentou efeito estatisticamente significativo, o grupo controle apresentou aumento de 0,17 pontos nesta variação quando comparado ao grupo intervenção ( h 2 = 0,07; p=0,004). A variação das Respostas de Evitação e do Nível Geral de Coping não evidenciou efeito estatisticamente significativo na interação grupo/tempo (respectivamente, p=0,471 e p=0,786). Conclusão A intervenção com Biofeedback cardiovascular demonstrou não ter efeito superior ao placebo na melhora dos níveis de coping .

Resumen Objetivo Evaluar el efecto del Biofeedback cardiovascular sobre los niveles de coping de los profesionales de enfermería de un hospital universitario, en comparación con una actividad informatizada sin automonitoreo. Métodos Ensayo clínico aleatorizado, con dos grupos, Biofeedback y placebo, realizado con 115 profesionales de enfermería de un hospital universitario. Los grupos participaron en nueve encuentros durante tres semanas. El desenlace fue evaluado por el Inventario de Respuestas de Coping en el Trabajo, versión brasileña, aplicado antes de la primera sesión e inmediatamente después de la sesión final. El análisis del desenlace se realizó por ANCOVA , considerando α = 5 %. Resultados La variación en las Respuestas de Afrontamiento presentó un efecto estadísticamente significativo. El grupo control presentó un aumento de 0,17 puntos en esta variación al compararlo con el grupo experimental ( h 2 = 0,07; p=0,004). La variación de las Respuestas de Evitación y del Nivel General de Coping no evidenció un efecto estadísticamente significativo en la interacción grupo/tiempo (respectivamente, p=0,471 y p=0,786). Conclusión La intervención con Biofeedback cardiovascular demostró que no tiene efecto superior al del placebo en la mejora en los niveles de coping .Registro do Clinical Trial: NCT04446689

Abstract Objective To assess the effect of cardiovascular biofeedback on coping levels of nursing professionals at a university hospital, when compared with a computerized activity without self-monitoring. Methods This is a randomized clinical trial, with two groups, biofeedback and placebo, carried out with 115 nursing professionals from a university hospital. The groups participated in nine meetings for three weeks. The outcome was assessed by Coping Responses Inventory, Brazilian version, applied prior to the first session and immediately after the final session. The outcome analysis was performed by ANCOVA, considering α = 5%. Results The Coping Responses variation had a statistically significant effect. The control group showed an increase of 0.17 points in this variation when compared to the intervention group (h 2 = 0.07; p=0.004). The Avoidance Responses variation and Overall Coping Level did not show a statistically significant effect on the group/time interaction (p=0.471 and p=0.786, respectively). Conclusion Intervention with cardiovascular biofeedback was shown to have no superior effect than placebo in improving coping levels.Clinical Trial Record: NCT04446689

Are static posturography-assisted biofeedback exercises effective in Parkinson's disease? / Os exercícios com biorretroalimentação assistidos por posturografia estática são eficazes na doença de Parkinson?

Abstract Background Parkinson disease (PD) is a progressive condition that causes disorders in movement and balance. Objective To evaluate the effectiveness of static posturography-assisted biofeedback exercises in PD-related balance disorder. Methods We screened 83 patients, 48 of whom were enrolled, and 41 completed the study. The sample was randomized into two groups, one submitted to static posturography-assisted biofeedback exercises and the other, to a conventional exercise program. The patients in the biofeedback group (n =20) performed biofeedback exercises in addition to conventional balance exercises. Those in the conventional exercise group (n = 21) performed classic balance exercises. Both groups were treated for 20 minutes per session 3 times a week for 6 weeks. The patients were evaluated using the Hoehn and Yahr Scale, the Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS), the Berg Balance Scale (BBS), the Tinetti Gait and Balance Assessment (TGBA), the Timed Up and GoTest (TUG), the Tandem Stance Test (TST), a Turkish version of the Stanford Health Assessment Questionnaire (HAQ), and the Beck Depression Inventory (BDI) before and at the end of the treatment. Results No statistically significant differences were observed between the two groups in terms of the MDS-UPDRS, BBS, TGBA, TST, TUG, HAQ, or BDI measurements before and after the treatment (p > 0.05). Conclusions Improved balance parameters were observed following balance training in the patients with PD, although static posturography-assisted biofeedback exercises appeared to provide no additional benefit. However, larger, randomized controlled trials are needed to investigate their effectiveness.

Resumo Antecedentes A doença de Parkinson (DP) é uma doença degenerativa que causa alterações no movimento e no equilíbrio. Objetivo Avaliar a eficácia dos exercícios com biorretroalimentação assistidos por posturografia estática na alterações do equilíbrio derivadas da DP. Métodos Selecionamos 83 pacientes, 48 dos quais foram incluídos, e 41 completaram o estudo. A amostra foi randomizada e dividida em dois grupos, um submetido a exercícios com biorretroalimentação assistidos por posturografia estática, e outro submetido a um programa de exercícios convencional. Os pacientes do grupo de biorretroalimentação (n = 20) fizeram exercícios com biorretroalimentação e exercícios convencionais de equilíbrio. E o grupo dos exercícios convencionais (n = 21), fez exercícios clássicos de equilíbrio. Ambos os grupos receberam tratamento durante 20 minutos por sessão, 3 vezes por semana, por 6 semanas. Os pacientes foram avaliados antes e depois do tratamento pela Escala de Hoehn e Yahr, Escala Unificada de Avaliação da Doença de Parkinson (EUADP) da Movement Disorder Society (MDS), a Escala de Equilíbrio Berg (EEB), Avaliação de Equilíbrio e Marcha Tinetti (AEMT), oTeste Timed Up and Go (TUG), o Teste de Apoio Tandem (TAT), a versão em turco do Questionário de Avaliação de Saúde (QAS) de Stanford, e o Inventário de Depressão de Beck (IDB). Resultados Não se observaram diferenças estatisticamente significativas entre os dois grupos quanto às mediçõesdo EUADP, EEB, AEMT, TAT, TUG, QAS ou IDB realizadas antes e depois do tratamento (p > 0.05). Conclusões Verificou-se uma melhoria dos parâmetros de equilíbrio após os exercícios de equilíbrio nos pacientes com DP, apesar de não ter sido detectado sem nenhum benefício adicional aparente dos exercícios com retroalimentação assistidos por posturografia estática. Contudo, é necessário efetuar ensaios maiores, randomizados e controlados para estudar a sua eficácia.

Neurofeedback therapy used to treat sleep bruxism in adult subjects: a scoping review protocol

ABSTRACT Purpose: to identify evidence regarding the treatment of sleep bruxism with neurofeedback, as well as gaps in such evidence, through mapping studies, and how treatment protocols were performed. Methods: the proposed review will be conducted in accordance with the JBI methodology for scope reviews. The search strategy will aim to locate published and unpublished studies. The main databases to search include MEDLINE, Embase, LILACS, PsycINFO, Web of Science and Scopus. Gray literature and relevant materials will be included. Two independent reviewers will select titles and abstracts for evaluation, according to the inclusion criteria for the review. The search results will be reported and presented in a PRISMA flowchart. Data will be extracted from materials included in the scoping review using a data extraction tool. The results found will be presented in an organized table with the variables, with data being presented through diagrams, narratives and tables. Conclusion: a narrative summary will be performed that will accompany the tabulated results and describe the relationship of these results with the objectives and questions of this scoping review, that may lead to encouraging further research on this topic, bringing a new clinical approach evidence to the management of sleep bruxism.

Visual outcomes of audio-luminous biofeedback training for a child with idiopathic nystagmus / Desfechos visuais de treinamento de biofeedback audioluminoso em criança com nistagmo idiopático

ABSTRACT Microperimetry biofeedback training is a vision rehabilitation method that involves the training of attention and oculomotor control, and the rehabilitation of poorly located and non-functional preferred retinal loci. It can significantly improve distance and near visual acuity in age-related macular degeneration. Previous studies have shown that biofeedback training using electrical nystagmography can reduce nystagmus amplitude and increase foveation time. However, these improvements have not been sustained following training sessions. We hereby report a pediatric case of idiopathic nystagmus in an 11-year old patient treated with microperimetric biofeedback to improve visual acuity and fixation stability. The training had a beneficial impact, positively affecting fixation stability as well as distance and near reading vision. Subjectively, improvement in quality of life was also reported. Conversely to previous studies, the positive effects in this case were maintained for as long as twelve months following therapy. To the best of our knowledge, this is the first case with long-term benefits to be reported in the literature.(AU)

RESUMO O treinamento de biofeedback por microperimetria é um método de reabilitação da visão que envolve treinamento de atenção, controle oculomotor e reabilitação do locus preferencial de fixação da retina. Esse treinamento pode melhorar significativamente a acuidade visual para longe e perto na degeneração macular relacionada à idade. Estudos anteriores mostraram que o treinamento de biofeedback usando a nistagmografia elétrica pode reduzir a amplitude do nistagmo e aumentar o período de foveação. Entretanto, os resultados não se mantiveram após o término das sessões. Aqui é relatado um caso de tratamento com biofeedback por microperimetria para melhorar a acuidade visual e a estabilidade de fixação em uma criança de 11 anos de idade. O treinamento teve impacto benéfico e afetou positivamente a estabilidade da fixação e a visão para longe, para perto e de leitura. Subjetivamente, foi relatada melhoria da qualidade de vida. Em contraste com estudos anteriores, os efeitos positivos foram mantidos até 12 meses após a terapia. Até onde sabemos, este é o primeiro caso na literatura que relata benefícios de longo prazo.(AU)

A new biofeedback approach for the control of awake bruxism and chronic migraine headache: utilization of an awake posterior interocclusal device / Uma nova abordagem via biofeedback para o controle do bruxismo de vigília e de enxaqueca crônica: utilização de um dispositivo interoclusal posterior em vigília

ABSTRACT Background: The relationship of bidirectional comorbidity between chronic migraine and pain in the cephalic segment led us to evaluate the improvement in reducing the pain in patients diagnosed with chronic migraine headache and awake bruxism, when undergoing treatment with a partial posterior interocclusal device designed for the management and control of awake bruxism through biofeedback. Methods: Seventy-four patients were evaluated during the following periods: pretreatment, seven, thirty, ninety, one hundred and eighty days, and one year. The evaluation was carried out by measuring the pain in the pretreatment period and pain reduction after awake bruxism treatment, using clinical evaluation and numerical scales for pain. Results: Most of the patients who complained of headache migraine pain, masticatory myofascial pain, temporomandibular joint and neck pain experienced a significant reduction in overall pain, including headaches, between t0 and t30 (p<0.0001). After 30 days of using the device, it was observed that the improvement remained at the same level without any recurrence of pain up to t90. At t180 and t360, it was observed that even with the device withdrawal (at t90) the improvement remained at the same level. Conclusion: The utilization of a posterior interocclusal device designed for the management and control of awake bruxism through biofeedback seems to contribute to the reduction of pain (including migraine headache) in the majority of patients, and, even with the device withdrawal (at t90), the improvement remained at the same level, suggesting the patients succeeded in controlling their awake bruxism and consequently the pains.

RESUMO Introdução: A relação de comorbidade bidirecional entre enxaqueca crônica e dor no segmento cefálico nos levou a avaliar a melhora na redução da dor em pacientes diagnosticados com cefaleia crônica de enxaqueca e bruxismo de vigília, quando submetidos a tratamento com dispositivo interoclusal posterior parcial projetado para o manejo e o controle do bruxismo acordado através de biorretroalimentação (biofeedback). Métodos: Setenta e quatro pacientes foram avaliados durante os seguintes períodos: pré-tratamento, sete, trinta, noventa e cento e oitenta dias, e um ano. A avaliação foi realizada por meio da avaliação da dor no período pré-tratamento e redução da dor após o tratamento do bruxismo de vigília, através de avaliação clínica e escalas numéricas de dor. Resultados: A maioria dos pacientes que se queixou de dor de cabeça com enxaqueca, dor miofascial mastigatória, articulação temporomandibular e dor no pescoço sofreu uma redução significativa na dor geral, incluindo dores de cabeça, entre t0 e t30 (p<0,0001). Após 30 dias de uso do dispositivo, observou-se que a melhora permaneceu no mesmo nível, sem recorrência da dor até t90. Em t180 e t360, observou-se que, mesmo com a retirada do dispositivo (em t90), a melhoria permaneceu no mesmo nível. Conclusão: A utilização de um dispositivo interoclusal posterior projetado para o controle do bruxismo de vigília através de biofeedback parece contribuir para a redução da dor (incluindo enxaqueca) na maioria dos pacientes, e, mesmo com a retirada do dispositivo (t90), a melhora manteve-se no mesmo nível, sugerindo que os pacientes conseguiram controlar o seu bruxismo de vigília e a dor associada a esse hábito.

Effects of adaptive biofeedback training on long-term efficacy and family maintenance treatment in patients with outlet obstruction constipation / 中华消化杂志

Objective To explore the effects of adaptive biofeedback training (ABF) on long-term efficacy and family maintenance treatment in patients with outlet obstruction constipation (OOC).Methods From October 2010 to April 2013,a total of 114 patients with OOC met Rome Ⅲ criteria were enrolled in this study.After six weeks ABF treatment,patients were divided into family maintenance treatment group and simple follow-up group.And then the scores of clinical constipation symptoms,weekly dosage of polyethylene glycol electrolyte powder,total clinical efficacy and satisfaction rate were recorded.T test and chi-square test were performed for statistical analysis.Results A total of 95 patients with OOC were enrolled in the follow-up study eventually,42 cases in family maintenance treatment group and 53 cases in simple follow-up group.After six weeks ABF treatment,the scores of clinical constipation symptoms and weekly dosage of polyethylene glycol electrolyte powder decreased in both two groups.At 36th month after six weeks ABF,in family maintenance treatment group,the score of clinical constipation symptoms and weekly dosage of polyethylene glycol electrolyte powder were 4.86 ±1.13 and (5.88 ± 1.14) packs,respectively,which were both lower than those before treatment (11.05 ±3.26 and (15.28±4.12) packs,respectively),and the differences were statistically significant (t =2.520,P =0.041;t =3.080,P=0.042).At 36th month after six weeks ABF,in simple follow-up group,the score of clinical constipation symptoms and weekly dosage of polyethylene glycol electrolyte powder were (7.12 ± 1.25) and (11.44±2.88) packs,compared with those before treatment (11.07 ± 2.86 and (15.77 ±3.78)packs),the difference was not statistically significant (both P＞0.05).At 36th month after six weeks ABF,in family maintenance treatment group,the total clinical efficacy and total satisfaction rates both were 71.4％ (30/42),compared with those at the end of treatment (88.1％ (37/42),83.3％ (35/42)),the difference was not statistically significant (both P＞0.05).In simple follow-up group,at 12th month after six weeks ABF,the total clinical efficacy and satisfaction rates were 69.8％ (37/53) and 66.0％ (35/53),compared with those at the end of treatment (88.7％ (47/53) and 84.9％ (45/53)),the difference was not statistically significant (both P＞0.05),at 24th months,the total clinical efficacy and satisfaction rates were 49.1％ (26/53) and 47.2％ (25/53),which were both lower than those at the end of treatment,and the differences were statistically significant (x2 =1.762,P=0.036;x2 =1.928,P=0.041).Conclusions The efficacy of ABF in the treatment of patients with OOC lasts less than two years.However,the family maintenance treatment can keep for three years,which may be an effective method to keep long-term efficacy in patients with OOC.

Evaluation of Efficacy of Biofeedback Therapy on Chronic Constipation / 胃肠病学

Chronic constipation(CC)is one of the most common gastrointestinal disorders. Treatment of CC includes drug and non-drug treatment. Biofeedback(BF)is a psychological behavior therapy and has become the first-line therapy of CC. However,the efficacy of BF reported varied substantially. This article reviewed the evaluation of efficacy of BF on CC.

Impact of adaptive biofeedback training on clinical efficacy,psychological status and quality of life in patient with outlet obstruction constipation / 中华消化杂志

Objective To explore the effects of adaptive biofeedback training(ABF)on efficacy of clinical efficacy,psychological status and life quality in patients with outlet obstruction constipation (OOC).Methods From June 2011 to October 2014,a total of 206 patients with OOC were enrolled. They were divided into ABF group and fixed biofeedback training (FBF)group.The clinical symptoms integral,clinical efficacy,psychological status and quality of life were observed before and eight weeks after treatment.Chi-square test or t-test was performed for statistical analysis.Results A total of 138 cases completed biofeedback training and were divided into ABF group (n=76)and FBF group (n=62). Before treatment,the total scores of clinical constipation symptoms of ABF and FBF groups were 10.95 ± 2.86 and 11 .20±2.23,respectively,which were 2.02±1 .10 and 2.98±1 .19 after treatment.The total scores of both groups decreased after treatment (t =2.60,2.45 ;both P 0.05).After treatment,the integral of each dimension of Chinese version of the MOS 36-item short form healtly survey (SF-36 )in ABF group and FBF group were both higher than those before treatment,and the differences were statistically significant (all P 0.05 ).Conclusions Both ABF and FBF can effectively improve clinical symptoms,psychological health and the quality of life in patients with OOC.However, ABF seems to be more effective and superior and more advantages.

Postpartum pelvic floor rehabilitation on prevention of female pelvic floor dysfunction:a multicenter prospective randomized controlled study / 中华妇产科杂志

Objective To study the postpartum pelvic floor rehabilitation on the improvement of pelvic floor electrical physiological indexes and the prevention of female pelvic floor dysfunction in China. Methods A multicenter prospective randomized controlled study was carried out. From October 2011, postpartum women in five provinces were randomly assigned into treatment group and control group. The women in treatment group received electrical stimulation and biofeedback treatment. The women in control group performed pelvic floor muscle exercise at home. When 6 months and 12 months after delivery, comparing two groups of patients with pelvic floor electrical physiological indexes and pelvic organ prolapse quantitation measurements (POP-Q), to evaluate the effect of postpartum pelvic floor rehabilitation on the prevention of pelvic floor dysfunction. Pelvic floor impact questionnaire short form (PFIQ-7) and pelvic organ prolapse/incontinence sexual questionnaire-12 (PISQ-12) were used to evaluate the influence on quality of life and sexual life. Results Until June 2013, 324 women were participated, 124 in control group, 200 in treatment group. According to the baseline results, there was statistical significance in the results of pelvic floor electrical physiological indexes between the treatment and control groups in postpartum 6 months and 12 months; the proportion above level Ⅲ of type Ⅰ and type Ⅱ muscle fibers strength in the treatment group, it was from 41.5% (83/200) and 40.5% (81/200) to 76.3% (145/190) and 79.5% (151/190) in postpartum 6 weeks and postpartum 6 months, increased to 80.6%(58/72) and 80.6%(58/72) in postpartum 12 months, improved significantly comparing with the control group (P0.05). There was no significant difference in the questionnaires in quality of life and quality of sexual life (P>0.05). Conclusion Neuromuscular electrical stimulation and biofeedback therapy in the early postpartum period could obviously improve pelvic floor electrical physiological indexes, and is beneficial to prevent the pelvic floor dysfunction.

Efficacy observation of pelvic floor muscle training combined with traditional Chinese medicine in the treatment of mild-moderate pelvic organ prolapse / 中国医师杂志

Objective To explore the rehabilitation effect of pelvic floor muscle training combined with traditional Chinese medicine in the treatment of mild-moderate pelvic organ prolapse.Methods A prospective ease-control study,choosing 103 patients of mild-moderate pelvic organ prolapse from October 2012 to May 2014 in Maternal and Child Health Hospital Outpatient of Hunan Province,which were randomly divided into study group (52 cases) and control group (51 cases).All of the patients underwent two courses of pelvic floor muscle training,including Kegel exercise,biofeedback,electrical stimulation therapy,the study group combined with traditional Chinese medicine (Buzhongyiqitang) at the same time.The efficacy was analyzed before and after treatment of pelvic floor muscle strength,myoelectric potential and indexing of pelvic organ prolapse quantification (POP-Q) changes.Results There werent statistically significant differences in type Ⅰ and Ⅲ muscle fiber muscle strength and myoelectric potential of two groups before treatment,while the shrinkage index improved significantly after treatment,and the study group was significantly higher with statistically significant difference (P ＜ 0.05).The effective rates of POP-Q indexing changes in two groups were 71.2％ and 56.9％,respectively.The effective rate of the study group was significantly higher than the control group(P ＜ 0.05).Conclusions The clinical efficacy of pelvic floor muscle training combined with Buzhongyiqitang in the treatment of mild-moderate pelvic organ prolapse was significant,and it had a good clinical value.

Biofeedback training during pregnancy decreases the risk of postpartum depression: a prospective randomized controlled trial / 中华围产医学杂志

Objective To explore the clinical function of biofeedback training in patients with high risks of postpartum depression,and to provide a new method to decrease the risk of postpartum depression.Methods From May 1,to December 31,2010,in Bayi Children's Hospital,General Hospital of Beijing Military Area Command of Chinese PLA,60 pregnant women with Edinburgh Postnatal Depression Scale (EPDS) evaluation score of 6 to 12 at 12～14 gestational weeks were randomly divided into the biofeedback training group (n=30) and the control group (n=30).The control group learned prenatal care knowledge in pregnant women's school.Moreover,the biofeedback training group received Self-generate Physiological Coherence System training till one week before delivery.Both groups were evaluated with the EPDS at baseline,and 3 days,6 weeks,3 months postpartum.Differences between the two groups were compared with mixed effect model.Results Totally,there were 51 pregnant women finished the study,including 25 women in the biofeedback training group and 26 in the control group.There were no statistical difference in EPDS score at 12～14 gestational weeks between the biofeedback training group and control group [8.5±2.0 vs 8.5±1.9,t=0.03,P=0.97].At 3 days,6 weeks and 3 months postpartum,the EPDS score of biofeedback training group was 4.1 ± 1.8,4.7 ± 2.0 and 4.6 ± 1.8 respectively,which was lower than those in the control group (6.5 ± 2.4,7.0 ± 2.5and 6.9±2.4) (interaction effect F=4.35,P=0.01).On each postpartum time-point,OR value and 95％CI was 0.12 (0.03-0.45),0.21 (0.06-0.68) and 0.23 (0.07-0.77),P＜0.05 respectively.Cohen's d value were 1.17,0.99 and 1.06 respectively.Compared with the baseline value,the total EPDS scores in each study stage declined with varied degrees in both groups,and the score-reducing level were obvious in the biofeedback training group than in the control group.Conclusion Biofeedback training could effectively relieve the depression symptoms in pregnant women with high risks of postpartum depression,and decrease the risk of postpartum depression.

Effect of pelvic floor muscle training with biofeedback on stress urinary incontinence in postpartum and post-menopausal women / 中华妇产科杂志

Objective To investigate the short-term effect of pelvic floor muscle training (PFM) with biofeedback on stress urinary incontinence (SUI) in postpartum and post-menopausal women.Methods According to the different period that the SUI occurs,107 women with SUI were divided into two groups:the group of SUI in postpartum with 60 women,and the group of SUI in post-menopausal with 47 women.PFM with biofeedback was performed on all patients for 8 weeks.One hour pad-weighing test,voiding diary,transperineal three-dimensional ultrasound and female pelvic floor muscle assessment were recorded before and after treatment.Results There was statistically significant difference in 1 hour padweighing test between pre-treatment and post-treatment for the group of SUI in postpartum (the negative,mild,moderate,and severe cases of post-treatment:21,24,14,1,of pre-treatment:0,30,28,2; P＜0.05),and the group of SUI in post-menopausal (the negative,mild,moderate,and severe cases of post-treatment:7,22,11,7,of pre-treatment:0,14,25,8; P＜0.05).The strength of the pelvic floor muscles of type Ⅰ and type Ⅱin two groups after treatment were significantly different from those in pre-treatment (P＜0.01).The efficient rate of improvement in symptoms after treatment in the group of SUI in postpartum was 88％ (53/60) and the cure rate was 38％ (23/60).While the efficient rate in the group of SUI in post-menopausal women was 64％(30/47) and the cure rate was 15％ (7/47).There was statistically significant difference in the development of symptoms in two groups after treatment (P=0.003).Conclusion PFM with biofeedback is an effective treatment for SUI in postpartum and post-menopausal women,especially for postpartum ones.

Bladder control training in girls with lower urinary tract dysfunction

Purpose To evaluate the efficacy of standard and biofeedback bladder control training (BCT) on the resolution of dysfunctional elimination syndrome (primary outcome), and on the reduction of urinary tract infections (UTI) and the use of medications such as antibacterial prophylaxis and/or anticholinergic/alpha-blockers (secondary outcome) in girls older than aged least 5 years. Materials and Methods 72 girls, median age of 8 years (interquartile range, IQR 7-10) were subjected to standard BCT (cognitive, behavioural and constipation treatment) and 12 one-hour sessions of animated biofeedback using interactive computer games within 8 weeks. Fifty patients were reevaluated after median 11 (IQR, 6-17) months. Effectiveness of BCT was determined by reduction of dysfunctional voiding score (DVS), daytime urinary incontinence (DUI), constipation, UTI, nocturnal enuresis (NE), post void residual (PVR), and improvements in bladder capacity and uroflow/EMG patterns. Results BCT resulted in significant normalization of DUI, NE, constipation, bladder capacity, uroflow/EMG, while decrease of PVR didn't reach statistical significance. In addition, the incidence of UTI, antibacterial prophylaxis and medical urotherapy significantly decreased. There were no significant differences in DVS, DUI, NE, bladder capacity and voiding pattern at the end of the BCT and at the time of reevaluation. The success on BCT was supported by parenteral perception of the treatment response in 63.9% and full response in additional 15.3% of the patients. Conclusion Combination of standard and biofeedback BCT improved dysfunctional elimination syndrome and decreased UTI with discontinuation of antibacterial prophylaxis and/or anticholinergic/alpha-blockers in the majority of the patients. Better training results are expected in patients with higher bladder wall thickness as well as in those with vesicoureteral reflux, ...

Long-term efficacy and the influencing factors analysis of biofeedback therapy in functional constipation / 中华消化杂志

Objective To evaluate the long-term efficacy and the influencing factors of biofeedback (BF) treatment in functional constipation (FC).Methods Totally 120 BF treated FC patients were retrospectively followed up.The clinical symptom score,the use of laxatives,the result of colonic transit test and anorectal manometry were compared before BF treatment and during follow-up.The long-term efficacy of biofeedback treatment was evaluated.Thirty-two possible influencing factors of long-term efficacy were selected and univariate and multivariate analysis were conducted.The groups were compared with t test,rank-sum test and x2 test.The influencing factors of long-term efficacy were analyzed with a stepwise multiple regression analysis.Results The median score of clinical symptoms in follow-up period (3) was significantly lower than that before BF treatment (10,Z=-7.900,P＜0.01).The total long-term efficacy rate was 70.6％ (77/109).During follow-up,the rate of laxatives use [39.4 ％ (43/109)] was lower than that before BF treatment [83.5％ (91/109),x2 =44.623,P＜0.01].During follow-up,the 48 hour median colonic emptying rate (30.0％)was higher than that before BF treatment (0,Z=-2.298,P=0.022).During follow-up,the proportion of patients with uncoordinated defecation (51.4％) was lower than that before BF treatment (77.1％,x2 =5.040,P=0.025).The results of univariate and multivariate analysis showed that the long-term efficacy of BF treatment was positively correlated with the compliance for home training and utilization of social support,negatively correlated with the course of disease.Conclusions BF therapy can improve clinical symptoms of FC patients,correct physiological dysfunction and have a satisfactory lon~term efficacy.Compliance for home training,utilization of social support and the course of disease were independent influencing factors.

Eficácia do biofeedback para o tratamento da incontinência urinária de esforço: uma revisão sistemática / Effectiveness of biofeedback for the treatment of stress urinary incontinence: a systematic review

Objetivos: o objetivo desta revisão foi sistematizar as evidências científicas sobre o uso de dispositivos biofeedback no tratamento da incontinência urinária de esforço em mulheres.Fonte de Dados: para a seleção das publicações, duas pesquisadoras buscaram identificar, separadamente, ensaios clínicos controlados e randomizados de intervenção sobre a incontinência urinária de esforço por meio de biofeedback em mulheres, nas bases de dados ISI Web of Knowlegde, PubMed/MedLine, LILACS, Colaboração Cochrane, SciELO e PEDro, com os descritores (Stress AND Incontinence AND Biofeedback). A qualidade metodológica dos estudos foi avaliada pela Escala de Jadad. Oito artigos foram revisados na íntegra, sendo que sete deles fizeram uso de dispositivos com probe vaginal e um utilizou eletrodos de superfície.Síntese dos Dados: em 75% dos estudos a intervenção com biofeedback levou a resultados superiores em comparação aos grupos sem a intervenção, em pelo menos um dos desfechos avaliados. Quanto à qualidade metodológica, quatro estudos obtiveram uma pontuação de três pontos na Escala de Jadad, e os demais tiveram uma pontuação inferior, sendo considerados de limitada qualidade metodológica.Conclusões: conclui-se que os dispositivos de biofeedback parecem ser uma opção efetiva para o tratamento da incontinência urinária de esforço; no entanto, novos estudos com maior rigor metodológico devem ser realizados abordando este tema.

Aims: The aim of this review was to systematize the scientific evidences on the use of biofeedback devices in the treatment of stress urinary incontinence in women.Source of Data: For the selection of the publications, two researchers searched separately for randomized controlled clinical trials about the intervention in the female stress urinary incontinence using biofeedback on the data bases ISI Web of Knowlegde, PubMed/Medline, LILACS, Cochrane Collaboration, SciELO and PEDro, with the Key Words (Stress AND Incontinence AND Biofeedback). The methodological quality of the studies was assessed by Jadad scale. Eight papers were revised in full, of which seven described the use of devices with vaginal probe and one used surface electrodes.Summary of Findings: In 75% of the studies, the intervention with biofeedback had better results in comparison with the other groups at least in one of the outcomes assessed. As for the methodological quality, four studies scored three points on the Jadad scale, and the others had a lower score and were considered of limited methodological quality. Conclusions: We concluded that biofeedback devices seem to be an effective option for the treatment of stress urinary incontinence. However, further studies with greater methodological rigor should be conducted addressing this topic.

Predictive Capability of Anorectal Physiologic Tests for Unfavorable Outcomes Following Biofeedback Therapy in Dyssynergic Defecation

The purpose of this study is to evaluate the predictive capability of anorectal physiologic tests for unfavorable outcomes prior to the initiation of biofeedback therapy in patients with dyssynergic defecation. We analyzed a total of 80 consecutive patients who received biofeedback therapy for chronic idiopathic functional constipation with dyssynergic defecation. After classifying the patients into two groups (responders and non-responders), univariate and multivariate analyses were performed to determine the predictors associated with the responsiveness to biofeedback therapy. Of the 80 patients, 63 (78.7%) responded to biofeedback therapy and 17 (21.3%) did not. On univariate analysis, the inability to evacuate an intrarectal balloon (P=0.028), higher rectal volume for first, urgent, and maximal sensation (P=0.023, P=0.008, P=0.007, respectively), and increased anorectal angle during squeeze (P=0.020) were associated with poor outcomes. On multivariate analysis, the inability to evacuate an intrarectal balloon (P=0.018) and increased anorectal angle during squeeze (P=0.029) were both found to be independently associated with a lack of response to biofeedback therapy. Our data show that the two anorectal physiologic test factors are associated with poor response to biofeedback therapy for patients with dyssynergic defecation. These findings may assist physicians in predicting the responsiveness to therapy for this patient population.

Clinical study on the biofeedback electrostimulation treatment for pelvic floor dysfunction disease / 中国医师进修杂志

Objective To investigate the influence of the biofeedback electrostimulation against the pelvic floor muscles to cure female pelvic floor dysfunction disease (PFD). Method Fifty-four female PFD patients treated with the biofeedback electrostimulation against the pelvic floor muscles by applying with different frequency and pulse width for different patients. Results The cure rate of the pelvic organ prolapse (POP) patients was 10.0%(1/10) and the cure rate of the post partum pelvic floor injury patients was 100.0%(32/32) except the stress urinary incontinence(SUI) patients. But the SUI patients improved efficacy rate was 91.7%(11/12) and the POP patients improved efficacy rate was 70.0%(7/10). The total efficacy rate was 94.4%(51/54). Conclusions It shows that the biofeedback electrostimulation against the pelvic floor muscles could cure the female PFD,reduce the disease morbidity of the PFD and improve the quality of female patient's lfie. As a result, the curing method could have clinical application prospect extensively.

Estudo sobre a efetividade da técnica de biofeedback em grupo de doentes com migrânea crônica / Study about the biofeedback technique effectiveness in group with chronic migrainers

O biofeedback (BFD) é uma estratégia terapêutica em que ocorre aprendizagem por associação de sensações com o propósito de controlá-las levando a melhor enfrentamento fornecendo novas respostas e permitindo novos padrões, mesmo que se mantenha a ativação dos estímulos originais disfuncionais. Em migranosos ocorreria inibição da expressão da angústia relacionada ao nível fisiológico, devido a persistência de estados induzidos de estresse. Pesquisas de enfrentamento da migrânea incluem tratamento por condicionamento operante, biofeeback e outras técnicas como tratamento psicodinâmico. Tais tratamentos apontam para a redução do reforçamento do comportamento doloroso e melhora de comportamentos adaptativos para o enfrentamento das dificuldades. Objetivo geral: verificar a efetividade da técnica do biofeeback térmico como tratamento auxiliar em migranosos, através do Multidimensional Pain Inventory (MPI), antes e depois da intervenção. População: 60 doentes (masculino e feminino); idade variando entre 20 e 60 anos, com duração dos sintomas superior à 6 meses; em condições de locomoção e retorno às consultas e aceite do termo de Consentimento Pós-Informado CAPPesq. Instrumentos e Procedimento: Entrevista psicológica semi-dirigida para doentes com dor, através de protocolo próprio (Perissinotti, 2001); PRIME-MD + Qp; ABIPEME; Multidimensional Pain Inventory - MPI; ProComp + BioGraph 2.1. Duas amostras randomizadas foram separadas: grupo experimental (30 doentes) e grupo comparativo (30 doentes). O procedimento foi composto por triagem e direcionamento para grupo experimental, treinamento por BFD, 10 sessões que objetivaram o treino de dimensão de sensibilização discriminativa; e para o grupo comparativo adotado tratamento médico preventivo com medicação profilática padrão, para crise de migrânea. Resultados: O BFD alterou o comportamento da amostra experimental estudada, ocorrendo melhora geral da adaptabilidade, quando dos cálculos pela análise paramétrica...

Biofeedback (BFD) is a therapeutic strategy in which occurs the learning by the sensations association, with the purpose of controlling them leading to a behavior of better copping because provides new responses permitting new patterns, even with a new activation of dysfunctional original stimuli. In migrainers there would be the inhibition of anger expression related to the physiological level due to persistence of stressor-induced activation states. The migraine management research includes operant behavior treatment, biofeeback and other techniques as psychodynamic treatments. These treatments point out to reduce the reinforcement for pain behaviors and to improve adaptative behaviors to copping difficulties. General Objective: Verify the thermal biofeeback technique effectiveness as an auxiliary treatment in migraine patients by Multidimensional Pain Inventory (MPI), before and after intervention. Population: 60 patients (female and male): variance age between 20 and 60 years old, symptoms duration superior to 6 months, in condition to locomotion, to return to consultation and acceptance of the Post-Informed Consenting Term CAPPesq. Instruments and Procedure: Semi-directed structured psychological interviews for pain patients by Owner Protocol (Perissinotti, 2001); PRIME MD + PQ; ABIPEME; Multidimensional Pain Inventory - MPI; ProComp + BioGraph 2.1. Two random samples were separated: experimental group (30 patients) and comparative group (30 patients). The procedure was composed by triage and directionless: for experimental group, the BFD training, 10 sessions for sensitive-discriminative dimension training; for comparative group, the preventive medical treatment with standard prophylactic medication for migraine crisis. Results: The BFD has interfered in the behavior of the experimental sample studied, occurring a general better in adaptability, when calculated the parametric analysis. When the analysis by qui-square test for qualitative variables...

Biofeedback therapy for myogenic fecal incontinence / 中国普通外科杂志

Objective To evaluate the effect of biofeedback therapy for the treatment of myogenic fecal incontinence. MethodsA general assessment about anorectal function was made on 17 cases receiving biofeedback therapy including muscle power training,sensory training and coordination training. Results The clinical scores before and after biofeedback therapy were 1.66?0.23,3.80?0.42 respectively,with an effective rate of 82%. The anus maximum contracting pressure elevated,(73?20) mm Hg vs. (123?30) mm Hg; myoelectric amplitude increased,(122?32) ?V vs. (230?41) ?V;Contracting time prolonged,(4.1?2.0) s vs. (9.4?3.0) s; The sensory threshold was lowered,(50?12) ml vs. ( 20? 10) ml;The feel-contract time increased,(3.1?0.4) s vs. (1.2?0.3) s. Positive rectal contraction reflex was seen in 41% patients before therapy compared with 82% after therapy. Conclusions Biofeedback therapy increases contractility of sphincter,decreases threshold of rectal sensory,and is a therapy of choice for myogenic fecal incontinence.