title: Randomised controlled trial comparing early home biofeedback physiotherapy with pelvic floor exercises for the treatment of third-degree tears (EBAPT Trial).
abstract: OBJECTIVE
  To compare early home biofeedback physiotherapy with pelvic floor exercises (PFEs) for the initial management of women sustaining a primary third-degree tear.
  
  
  METHODS
  Single centre, randomised trial.
  
  
  METHODS
  National Maternity Hospital, Dublin, Ireland.
  
  
  METHODS
  A total of 120 women sustaining a primary third-degree tear.
  
  
  METHODS
  Women were randomised in a one to three ratio: 30 to early postpartum home biofeedback physiotherapy and 90 to PFEs.
  
  
  METHODS
  Differences in anorectal manometry results, Cleveland Clinic continence scores and Rockwood faecal incontinence quality of life scale scores after 3 months of postpartum treatment.
  
  
  RESULTS
  The mean anal resting pressure was 39 ± 13 mmHg in the early biofeedback physiotherapy group and 43 ± 17 mmHg in the PFE group. The mean anal squeeze pressure was 64 ± 17 mmHg in the biofeedback group and 62 ± 23 mmHg in the PFE group. There was no significant difference in anal resting and squeeze pressure values between the groups (P = 0.123 and P = 0.68, respectively). There were no differences in symptom score and quality of life measurements between the groups.
  
  
  CONCLUSIONS
  This study demonstrates no added value in using early home biofeedback physiotherapy in the management of women sustaining third-degree tears. Poor compliance may have contributed because women found it difficult to designate time to using biofeedback.
authors.affiliation: National Maternity Hospital, Dublin, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Peirce
authors.forename: C
authors.initials: C
authors.lastname: Murphy
authors.forename: M
authors.initials: M
authors.lastname: Fitzpatrick
authors.forename: M
authors.initials: M
authors.lastname: Cassidy
authors.forename: L
authors.initials: L
authors.lastname: Daly
authors.forename: P R
authors.initials: PR
authors.lastname: O'Connell
authors.forename: C
authors.initials: C
authors.lastname: O'Herlihy
mesh_terms: D001003:Anal Canal / Q000293:injuries* / Q000502:physiology; D001676:Biofeedback, Psychology; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004841:Episiotomy; D005081:Exercise Therapy / Q000379:methods*; D005242:Fecal Incontinence / Q000517:prevention & control; D005260:Female; D006801:Humans; D022125:Lacerations / Q000209:etiology / Q000628:therapy*; D008365:Manometry; D036801:Parturition; D017773:Pelvic Floor / Q000502:physiology; D010502:Perineum / Q000293:injuries*; D049590:Postpartum Period; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Biofeedback physiotherapy; faecal incontinence; pelvic floor exercises; pudendal nerve injury; third-degree tear