title: The effect of EMG biofeedback assisted pelvic floor muscle therapy on symptoms of the overactive bladder syndrome in women: A randomized controlled trial.
abstract: OBJECTIVE
  The overactive bladder syndrome (OAB) is defined as urinary urgency, usually accompanied by frequency and nocturia, with or without urgency urinary incontinence. Biofeedback-assisted pelvic muscle therapy (BAPFMT) is a first-line treatment option for OAB. The aims of this study were to determine the efficacy and effectiveness of BAPFMT on symptoms of OAB after 9 weeks of treatment and to detect changes EMG activity of individual pelvic floor muscles (PFM) with the MAPLe.
  
  
  METHODS
  Patients were randomly divided into an intervention group that received BAPFMT with the MAPLe or into a control group which received only toilet behavior and lifestyle instructions. The Pelvic Floor Inventories (PeLFIs), the King's Health Questionnaire (KHQ), a voiding dairy, a 24 h pad-test, and vaginal EMG registration of the pelvic floor with the MAPLe were used at inclusion and after 9 weeks follow-up to determine the effect of BAPFMT on complaints of OAB and Quality of Life (QoL).
  
  
  RESULTS
  Fifty-eight patients were included. The PeLFIs, KHQ, voiding dairy, and 24 h pad-test showed significant improvements in the intervention group compared to the control group in complaints of OAB and QoL. EMG activity showed significant improvements for specific individual muscles at the different sides and depths for rest, maximal voluntary contraction, and endurance.
  
  
  CONCLUSIONS
  EMG BAPFMT is effective in the OAB syndrome in women. It significantly reduces symptoms and complaints of OAB and increases QoL for patients. It shows that EMG changes in individual PFM, measured with the MAPLe, are relevant and related to symptom reduction.
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jeroen C
authors.initials: JC
authors.lastname: Voorham
authors.affiliation: Department of Urology, University Hospital Antwerpen, Antwerpen, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: De Wachter
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Tine W L
authors.initials: TWL
authors.lastname: Van den Bos
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Guus A
authors.initials: GA
authors.lastname: Lycklama À Nijeholt
authors.affiliation: Department of Urology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Petra J
authors.initials: PJ
authors.lastname: Voorham-van der Zalm
mesh_terms: D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017773:Pelvic Floor / Q000503:physiopathology*; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000628:therapy*; D014549:Urinary Incontinence / Q000503:physiopathology / Q000628:therapy*; D014554:Urination / Q000502:physiology
keywords: EMG biofeedback assisted pelvic floor therapy; elektromyography; overactive bladder; quality of life; randomized controlled trial; urge urinary incontinence; urgency/frequency