Urinary incontinence severely affects the quality of life of many women. Physical therapists address this dysfunction with muscle strengthening and other function focused behavioral treatments. This study was designed to compare functional outcomes between biofeedback and verbal instruction for pelvic floor training in women with stress, urge, and mixed incontinence. Twenty women (age 31 to 80) were randomly assigned into 2 groups and participated in treatment 1 time per week for 8 weeks. The program consisted of pelvic floor strengthening, urge suppression techniques, and diet/fluid/lifestyle modification. Additionally, 1 group uses visual feedback via biofeedback during the pelvic floor strengthening. Functional outcomes were measured by a patient administered log of the number of leaks per week and the number of sanitary pads used per week. Measurements were recorded at baseline, 4 weeks, and 8 weeks. Maximum surface EMG and endurance over 10 seconds EMG reading were also taken. Both groups showed significant improvements in the above measures, but there was not a significant difference between the 2 groups in either the amount of improvement or the time needed to obtain those improvements. The biofeedback and verbal instruction groups both showed a large decrease in the number of leaks per week, 83% and 75% respectively. Number of pads used per week proved an unreliable measurement of incontinence secondary to personal preference and habitual behaviors. Overall both groups showed an improvement in surface EMG measurements in both maximum contractions and 10-second endurance, although these measurements were not analyzed statistically because surface EMG is not suited for quantitative reliability. These results indicate that pelvic floor training, which resulted in an improvement in incontinence symptoms, can be obtained with our without biofeedback training.

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