title: Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women: shortened version of a Cochrane systematic review.
abstract: BACKGROUND
  Feedback and biofeedback (BF) are common adjuncts to pelvic floor muscle training (PFMT) for women with stress, urgency, and mixed urinary incontinence (UI). An up to date systematic review of adjunctive feedback or BF was needed to guide practice and further research.
  
  
  OBJECTIVE
  To determine whether feedback or BF add benefit to PFMT for women with UI.
  
  
  METHODS
  The Cochrane Incontinence Group Specialised Trials Register was searched (May 2010) for randomised or quasi-randomized trials in women with stress, urgency or mixed UI regardless of cause, which compared PFMT versus PFMT augmented with feedback or BF. Two reviewers independently undertook eligibility screening, risk of bias assessment and data extraction. Analysis was in accordance with the Cochrane Handbook for Systematic Reviews of Intervention (version 5.0.2).
  
  
  RESULTS
  Twenty-four trials were included, and many were at moderate to high risk of bias. Women who received BF were less likely to report they were not improved (RR 0.75, 95% CI: 0.66-0.86), although there was no statistically significant difference for cure (RR 0.92, 95% CI: 0.81-1.05) and marginal statistical significance for leakage episodes (mean difference: -0.12 leaks/day, 95% CI: -0.22 to -0.01). It is possible the results are confounded because women in the BF group commonly had more contact with the health professional than those in the PFMT only arm.
  
  
  CONCLUSIONS
  BF may add benefit to PFMT but the observed effect could well be related to another variable, such as the amount of health professional contact rather than the BF per se.
authors.affiliation: Department of Obstetrics & Gynaecology Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands. roselien.herderschee@gmail.com
authors.forename: Roselien
authors.initials: R
authors.lastname: Herderschee
authors.forename: E C Jean
authors.initials: EC
authors.lastname: Hay-Smith
authors.forename: G Peter
authors.initials: GP
authors.lastname: Herbison
authors.forename: Jan Paul
authors.initials: JP
authors.lastname: Roovers
authors.forename: Maas Jan
authors.initials: MJ
authors.lastname: Heineman
mesh_terms: D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology / Q000502:physiology*; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D005081:Exercise Therapy / Q000379:methods*; D025461:Feedback, Physiological / Q000502:physiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D017773:Pelvic Floor / Q000502:physiology*; D017594:Publication Bias; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000628:therapy*