title: Supplementary home biofeedback improves quality of life in younger patients with fecal incontinence.
abstract: BACKGROUND
  Biofeedback is a scarce, resource-intensive clinical therapy. It is used to treat patients with bowel problems, including fecal incontinence (FI), who fail to respond to simple dietary advice, medication, or pelvic floor exercises. Populations are aging and younger cohorts use technology in managing their health, affording FI self-management opportunities.
  
  
  OBJECTIVE
  Does supplementary home-based biofeedback improve FI and quality of life (QOL)?
  
  
  METHODS
  Seventy-five incontinent participants (12 male), mean age 61.1 years, consented to participate. Thirty-nine patients (5 male) were randomized to the standard biofeedback protocol plus daily home use of a Peritron perineometer (intervention) and 36 patients (7 male) to the standard biofeedback protocol (control). On completion of the study each perineometer exercise session was rated for technique by 2 raters, blinded to the patient and order of sessions.
  
  
  RESULTS
  With the exception of Fecal Incontinence Quality of Life Scale lifestyle improvement (intervention--9.1% vs. controls--0.3%, P=0.026) and embarrassment improvement (intervention--50.0% vs. controls--18.3%, P=0.026), supplementary home biofeedback did not result in greater clinical improvement for the intervention group as a whole. However, on stratification around the mean age, continence and QOL of younger people in the intervention group were significantly better than those of their control counterparts. Graphed perineometer sessions demonstrated high compliance and improvement in exercise technique. Perineometers provided reassurance, motivation, and an exercise reminder ensuring that confidence was achieved quickly.
  
  
  CONCLUSIONS
  Home biofeedback was acceptable and well tolerated by all users. Younger participants significantly benefited from using this technology.
authors: *School of Public Health, Tropical Medicine & Rehabilitation Science ‡School of Medicine and Dentistry §The Australian Institute of Tropical Medicine, James Cook University †Clinical Measurements Unit, Townsville Hospital, Townsville, QLD, Australia.
authors: Lynne
authors: L
authors: Bartlett
authors: Kathryn
authors: K
authors: Sloots
authors: Madeleine
authors: M
authors: Nowak
authors: Yik-Hong
authors: YH
authors: Ho
mesh_terms: D000367:Age Factors; D001003:Anal Canal / Q000503:physiopathology; D001676:Biofeedback, Psychology / Q000295:instrumentation*; D005081:Exercise Therapy / Q000295:instrumentation*; D005242:Fecal Incontinence / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction; D017060:Patient Satisfaction; D011788:Quality of Life; D012648:Self Care; D020377:Self Efficacy; D012752:Shame; D016037:Single-Blind Method