Takaisin

Biofeedback enhanced pelvic floor muscle training in treatment of urinary incontinence

Näytönastekatsaukset
Olavi Airaksinen and Aleksi Raudasoja
31.3.2026

Level of evidence: D

The evidence on Pelvic Floor Muscle Training (PFMT) with EMG Biofeedback (EMG-BF) is very uncertain.

A systematic review and meta-analysis of including biofeedback in pelvic muscle training to treat stress urinary incontinence found uncertain impact on urinary incontinence symptoms (ICIQ-UI SF) «Wu X, Zheng X, Yi X, et al. Electromyographic Biof...»1.

Cure and improvement of incontinence due to stress Urinary Incontinence (SUI) were analyzed in 11 RCTs. EMG-BF+PFMT increased the rate of cure or improvement compared to PFMT alone (OR 4.82, 95% CI 2.21–10.51). However, the evidence was very uncertain. Only one study was conducted outside of China. The trial was the largest and high quality including 600 patients and found no difference between the intervention and control groups (OR 0.93, 95% CI 0.63 to 1.37).

Table 1. Description of the included studies.
Reference Study type Population Intervention and comparison Outcomes Risk of bias
MA=meta-analysis
«Wu X, Zheng X, Yi X, et al. Electromyographic Biof...»1 MA Women with Stress Urinary Incontinence (SUI) PFMT+ EMG_BF vs PFMT alone. Cure or improvement of Incontinence High
Table 2. Additional comments for included studies.
Reference Comments
«Wu X, Zheng X, Yi X, et al. Electromyographic Biof...»1 The used outcome measures varied. No blinding. Substantial loss to follow up. 17/21 trials were conducted in China.

Results

Table 3. Outcome 1: Total incontinence symptoms (ICIQ-UI SF).
Reference Number of studies and number of patients (I/C) Follow-up time Mean (SD) I Mean (SD) C Standardized mean difference (95% CI)
Level of evidence: very low
Quality of evidence was downgraded due to high risk of bias and imprecision.
I=intervention; C=comparison; CI=confidence interval
«Wu X, Zheng X, Yi X, et al. Electromyographic Biof...»1 4 trials (484/478) 1 – 24 months Not reported Not reported -0.52 (-2.17 to 1.12)
Table 4. Outcome 2: Cure or Improvement of Incontinence.
Reference Number of studies and number of patients (I/C) Follow-up time Mean (SD) I Mean (SD) C Odds Ratio (95% CI)
Level of evidence: very low
The quality of evidence was downgraded due to high risk of bias, indirectness and imprecision
I=intervention; C=comparison; CI=confidence interval
«Wu X, Zheng X, Yi X, et al. Electromyographic Biof...»1 10 trials 1–24 months Not reported Not reported, 4.82, 95% (2.21–10.51)

References

  1. Wu X, Zheng X, Yi X, et al. Electromyographic Biofeedback for Stress Urinary Incontinence or Pelvic Floor Dysfunction in Women: A Systematic Review and Meta-Analysis. Adv Ther 2021;38(8):4163-4177 «PMID: 34176082»PubMed