Author(s):
Nur Yanti Hariana Bt. Othman, Naresh Bhaskar Raj, Naing NN, Mahadeva Rao US, Enie Akhtar, Lee Wan Zhen, Anuar Md Zain
Email(s):
bnaresh@unisza.edu.my
DOI:
10.52711/0974-360X.2022.00308 
Address:
Nur Yanti Hariana Bt. Othman1,2, Naresh Bhaskar Raj3*, Naing NN4, Mahadeva Rao US5, Enie Akhtar6, Lee Wan Zhen7, Anuar Md Zain8
1Senior Physiotherapist, Women Health Unit, Hospital Raja Perempuan Zainab II, 15586 Kota Bharu, Kelantan.
2Post graduate student, Faculty of Health Science, Universiti Sultan Zainal Abidin (UniSZA), 21300 Terengganu, Malaysia.
3Senior Lecturer, Faculty of Health Science, Universiti Sultan Zainal Abidin (UniSZA), 21300 Terengganu, Malaysia.
4Professor, Faculty of Medicine, Universiti Sultan Zainal Abidin (UniSZA), Terengganu, Malaysia.
5Professor, School of Basic Medical Sciences, Universiti Sultan Zainal Abidin (UniSZA), Kuala Terengganu, Malaysia.
6Obstetric and Gynaecology Specialist and Urogynaecology Specialist, Department of Obstetrics and Gynaecology, Hospital Raja Perempuan Zainab II, 15586 Kota Bharu, Kelantan.
7Lecturer, Faculty of Health Science, Universiti Sultan Zainal Abidin (UniSZA), 21300 Terengganu, Malaysia.
8Senior Lecturer,
Published In:
Volume - 15,
Issue - 4,
Year - 2022
ABSTRACT:
Various interventions are available for preventing and treating urinary incontinence, including medication, medical devices, and surgery. Some of the patients are not keen on surgical intervention, and pelvic floor muscle training (PFMT) will be another treatment option for female urinary incontinence. The current research aims to assess the effect of pelvic floor muscle training with biofeedback on improving the strength of the pelvic floor muscle, the severity of SUI, and quality of life among females with stress urinary incontinence. A random sampling of 10 patients with stress urinary incontinence (SUI) referred to the physiotherapy department by urogynecology department, Hospital Raja Perempuan Zainab II (HRPZ II), were recruited into the study of PFMT with biofeedback after a baseline assessment of the severity of stress urinary incontinence, strength, and quality of life. They were evaluated at baseline, at the 4th week, the 8th week of intervention, and a follow-up was done at the 12th week. The outcomes were measured with the incontinence severity index, perineometer, and incontinence impact questionnaire—Short Form IIQ-7. The results showed that there was a significant difference in mean SUI severity (F = 37.81, p= 0.001), strength (F = 15.44, p = 0.002), and quality of life (F = 104.11, p = 0.001) based on time. As a conclusion, pelvic floor muscle training with biofeedback is an assistive device that has significant effectiveness in the conservative treatment of stress urinary incontinence in female patients.
Cite this article:
Nur Yanti Hariana Bt. Othman, Naresh Bhaskar Raj, Naing NN, Mahadeva Rao US, Enie Akhtar, Lee Wan Zhen, Anuar Md Zain. Effect of Pelvic Floor Muscle Training with Biofeedback on Stress Urinary Incontinence in Females, Kelantan, Malaysia: A pilot study. Research Journal of Pharmacy and Technology. 2022; 15(4):1831-6. doi: 10.52711/0974-360X.2022.00308
Cite(Electronic):
Nur Yanti Hariana Bt. Othman, Naresh Bhaskar Raj, Naing NN, Mahadeva Rao US, Enie Akhtar, Lee Wan Zhen, Anuar Md Zain. Effect of Pelvic Floor Muscle Training with Biofeedback on Stress Urinary Incontinence in Females, Kelantan, Malaysia: A pilot study. Research Journal of Pharmacy and Technology. 2022; 15(4):1831-6. doi: 10.52711/0974-360X.2022.00308 Available on: https://www.rjptonline.org/AbstractView.aspx?PID=2022-15-4-74
REFERENCES:
1. https://www.statistica.com/statistic/713529/Malaysia_aging_population; 9.52pm; 4/12/18.
2. Palma P and Lorenzetti F. Epidemiology. Informa Healthcare, South America. 2010.
3. Buckley BS, Lapitan MC. Prevalence of urinary incontinence in men, women, and children—current evidence: findings of the Fourth International Consultation on Incontinence. Urology. 2010 Aug 1;76(2):265-70. doi: 10.1016/j.urology.2009.11.078
4. Hunskaar S, Burgio K, Diokno A, Herzog AR, Hjälmås K, Lapitan MC. Epidemiology and natural history of urinary incontinence in women. Urology. 2003 Oct 1;62(4):16-23. doi:10.1007/s001920070021
5. Markland AD, Richter HE, Fwu CW, Eggers P, Kusek JW. Prevalence and trends of urinary incontinence in adults in the United States, 2001 to 2008. The Journal of urology. 2011 Aug 1;186(2):589-93. doi: 10.1016/j.juro.2011.03.114
6. Haylen BT, De Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, Monga A, Petri E, Rizk DE, Sand PK, Schaer GN. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourology and Urodynamics: Official Journal of the International Continence Society. 2010 Jan;29(1):4-20. doi:10.1007/s00192-009-0976-9
7. Ashton‐Miller JA, Delancey JO. Functional anatomy of the female pelvic floor. Annals of the New York Academy of Sciences. 2007 Apr;1101(1): 266-96.doi:10.1196/annals.1389.034
8. Wing RR, Creasman JM, West DS, Richter HE, Myers D, Burgio KL, Franklin F, Gorin AA, Vittinghoff E, Macer J, Kusek JW. Improving urinary incontinence in overweight and obese women through modest weight loss. Obstetrics and gynecology. 2010 Aug;116(2 Pt 1):284. Doi:10.1097/AOG.0b013e3181e8fb60
9. Giarenis I, Cardozo L. Managing urinary incontinence: what works? Climacteric. 2014 Dec 1;17(sup2):26-33. doi: 10.3109/13697137.2014.947256
10. Burgio KL. Update on behavioral and physical therapies for incontinence and overactive bladder: the role of pelvic floor muscle training. Current urology reports. 2013 Oct;14(5):457-64. doi: 10.1007/s11934-013-0358-1
11. Ong TA, Khong SY, Ng KL, Ting JR, Kamal N, Yeoh WS, Yap NY, Razack AH. Using the Vibrance Kegel device with pelvic floor muscle exercise for stress urinary incontinence: a randomized controlled pilot study. Urology. 2015 Sep 1;86(3):487-91. doi: 10.1016/j.urology.2015.06.022
12. Dumoulin C, Hunter KF, Moore K, Bradley CS, Burgio KL, Hagen S, Imamura M, Thakar R, Williams K, Chambers T. Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: Summary of the 5th International Consultation on Incontinence. Neurourology and urodynamics. 2016 Jan;35(1):15-20. doi: 10.1002/nau.22677
13. Capobianco G, Madonia M, Morelli S, Dessole F, De Vita D, Cherchi PL, Dessole S. Management of female stress urinary incontinence: a care pathway and update. Maturitas. 2018 Mar 1; 109:32-8. doi: 10.1016/j.maturitas.2017.12.008
14. Dumoulin C, Hay‐Smith J, Habée‐Séguin GM, Mercier J. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women: a short version Cochrane systematic review with meta‐analysis. Neurourology and urodynamics. 2015 Apr;34(4):300-8. doi: 10.1002/nau.22700
15. Bø K. Pelvic floor muscle training in treatment of female stress urinary incontinence, pelvic organ prolapses and sexual dysfunction. World journal of urology. 2012 Aug;30(4):437-43. doi: 10.1007/s00345-011-0779-8
16. El-Bandrawy AM, Botla AM, El-Refaye GE, Ghareeb HO. Efficacy of Biofeedback-Assisted Pelvic Floor Muscle Training on Postoperative Stress Urinary Incontinence. International Journal of Medical and Health Sciences. 2016 Apr 2;10(5):294-8. doi: 19999-9/10004663
17. Moroni RM, Magnani PS, Haddad JM, Castro RD, Brito LG. Conservative treatment of stress urinary incontinence: a systematic review with meta-analysis of randomized controlled trials. Revista Brasileira de Ginecologia e Obstetrícia. 2016;38:97-111.doi: 10.1055/s-0035-1571252
18. Knight SJ, Laycock J. The role of biofeedback in pelvic floor re-education. Physiotherapy. 1994 Mar 10;80(3):145-8. doi: 10.1016/S0031-9406(10)61264-3
19. Kari B, Berghmans B, Morkved S, Van Kampen M, editors. Evidence-Based Physical Therapy for the Pelvic Floor: Bridging Science and Clinical Practice. Churchill Livingstone; 2015.
20. Bumsz PA, Pranikoff K, Nochajski TH, Hadley EC, Levy KJ, Ory MG. A comparison of effectiveness of biofeedback and pelvic muscle exercise treatment of stress incontinence in older community-dwelling women. Journal of Gerontology. 1993 Jul 1;48(4):M167-74. doi: 10.1093/geronj/48.4.M167
21. Berghmans LC, Frederiks CM, De Bie RA, Weil EH, Smeets LW, Van Waalwijk van Doorn ES, Janknegt RA. Efficacy of biofeedback, when included with pelvic floor muscle exercise treatment, for genuine stress incontinence. Neurourology and Urodynamics: Official Journal of the International Continence Society. 1996;15(1):37-52. doi:10.1002/(SICI)1520-6777(1996)15:1<37:AID-NAU4>3.0.CO;2-G
22. Demirturk F, Akbayrak T, Karakaya IC, Yuksel I, Kirdi N, Demirturk F, Kaya S, Ergen A, Beksac S. Interferential current versus biofeedback results in urinary stress incontinence. doi: 11655/20966
23. Radzimińska A, Strączyńska A, Weber-Rajek M, Styczyńska H, Strojek K, Piekorz Z. The impact of pelvic floor muscle training on the quality of life of women with urinary incontinence: a systematic literature review. Clinical interventions in aging. 2018;13:957. doi: 10.2147/CIA.S160057
24. Billingham SA, Whitehead AL, Julious SA. An audit of sample sizes for pilot and feasibility trials being undertaken in the United Kingdom registered in the United Kingdom Clinical Research Network database. BMC medical research methodology. 2013 Dec;13(1):1-6. doi: 10.1186/1471-2288-13-104
25. Hanley J, Capewell A, Hagen S. Validity study of the severity index, a simple measure of urinary incontinence in women. Bmj. 2001 May 5;322(7294):1096-7. doi: 10.1136/bmj.322.7294.1096
26. Varella LR, Torres VB, Angelo PH, de Oliveira MC, de Barros AC, Viana ED, CabralMicussi MT. Influence of parity, type of delivery, and physical activity level on pelvic floor muscles in postmenopausal women. Journal of physical therapy science. 2016;28(3):824-30. doi: 10.1589/jpts.28.824
27. Pereira VS, Hirakawa HS, Oliveira AB, Driusso P. Relationship among vaginal palpation, vaginal squeeze pressure, electromyographic and ultrasonographic variables of female pelvic floor muscles. Brazilian journal of physical therapy. 2014 Oct 10; 18:428-34. doi: doi.org/10.1590/bjpt-rbf.2014.0038
28. Navarro Brazález B, Torres Lacomba M, de la Villa P, Sánchez Sánchez B, Prieto Gómez V, Asúnsolo del Barco Á, McLean L. The evaluation of pelvic floor muscle strength in women with pelvic floor dysfunction: a reliability and correlation study. Neurourology and urodynamics. 2018 Jan;37(1):269-77. doi: 10.1002/nau.23287
29. Nusee Z, Rusly A, Jamalludin AR, Abdulwahab DF, Ismail R. Translation and validation of Bahasa Malaysia version of Urogenital Distress Inventory (UDI-6) and Incontinence Impact Quality of life questionnaires (IIQ-7), a cross sectional study. The Malaysian journal of medical sciences: MJMS. 2016 May;23(3):57. doi:27418870
30. Minassian VA, Devore E, Hagan K, Grodstein F. Severity of urinary incontinence and effect on quality of life in women, by incontinence type. Obstetrics and gynecology. 2013 May;121(5):1083. doi: 10.1097/AOG.0b013e31828ca761
31. Nygaard CC, Schreiner L, Morsch TP, Saadi RP, Figueiredo MF, Padoin AV. Urinary incontinence and quality of life in female patients with obesity. Revista Brasileira de Ginecologia e Obstetrícia. 2018; 40:534-9. doi: 10.1055/s-0038-1670626
32. Lamerton TJ, Torquati L, Brown WJ. Overweight and obesity as major, modifiable risk factors for urinary incontinence in young to mid-aged women: a systematic review and meta-analysis. Obesity Reviews. 2018 Dec 1;19(12):1735-45.doi: 10.1111/obr.12756
33. Lasak AM, Jean-Michel M, Le PU, Durgam R, Harroche J. The role of pelvic floor muscle training in the conservative and surgical management of female stress urinary incontinence: does the strength of the pelvic floor muscles matter?. PM&R. 2018 Nov 1;10(11): 1198-210.doi: 10.1016/j.pmrj.2018.03.023
34. Vahdatpour B, Tahmasebi A, Zargham M, Emad MR, Rezaei M. The Effect of Biofeedback versus Functional Electrical Stimulation in the Treatment of Stress Urinary Incontinence. Journal of Rehabilitation Sciences & Research. 2019 Jun 1;6(2):63-7. doi: 10.30476/JRSR.2019.75399.
35. Angelo PH, Varella LR, de Oliveira MC, Matias MG, de Azevedo MA, de Almeida LM, de Azevedo PR, Micussi MT. A manometry classification to assess pelvic floor muscle function in women. PLoS One. 2017 Oct 30;12(10): e0187045.doi: 10.1371/journal.pone.0187045
36. Barbosa PB, Franco MM, Souza FD, Antônio FI, Montezuma T, Ferreira CH. Comparison between measurements obtained with three different perineometers. Clinics. 2009 Jun;64(6):527-33.doi: 10.1590/s1807-59322009000600007
37. Wong KS, Fung KY, Fung SM, Fung CW, Tang CH. Biofeedback of pelvic floor muscles in the management of genuine stress incontinence in Chinese women: randomised controlled trial. Physiotherapy. 2001 Dec 1;87(12):644-8. 10.1016/S0031-9406(05)61109-1
38. Sahin N, Yesil H, Gorcan B. The effect of pelvic floor exercises performed with EMG biofeedback or a vaginal cone on incontinence severity, pelvic floor muscle strength, and quality of life in women with stress urinary incontinence: a randomized, 6-month follow-up study. International Urogynecology Journal. 2022 Jan 14:1-7. doi: 10.1007/s00192-021-05006-3