BIOFEEDBACK FOR PELVIC MUSCLES
WHAT IS IT?
HOW DOES IT WORK?
Biofeedback is a procedure used to gain awareness and control of the pelvic muscles. Electrodes (small stick-on pads placed on the skin) or patient-inserted internal sensors (like a tampon or suppository) are used to “feed back” information about the activity in the pelvic muscles at rest and during exercise.
The sensor or electrodes are attached to a computerized instrument that records information about pelvic muscle activity to a color screen so both patient and physical therapist can see how the muscles are actually working. Patients are fully clothed during biofeedback and there are no side effects.
Another example of biofeedback in our daily life is the bathroom scale, which provides “feedback” about our weight. We can use that information to modify our diet and exercise patterns accordingly.
Using the information provided by our pelvic muscles during biofeedback, an individual can learn how to better isolate the muscles for strengthening, or how to relax them in order to urinate and defecate more easily. Another use of biofeedback is for assisting in relaxation of pelvic muscles when there is pain in that region.
Your physical therapist will give you information about where the pelvic floor muscles are, how they work, and how you can use them to achieve better bowel or bladder control, and decrease pain caused by muscle spasm.
What are the benefits of biofeedback?
- Safe, non-invasive
- Effective – success rate as high as 95% (in various conditions)
- Can be used in conjunctions with other treatment options
For the treatment of incontinence, pelvic muscle exercise and inhibition using biofeedback therapy has received the highest rating possible by the Agency for Health Care Policy and Research Clinical Practice Guideline.
How Does Biofeedback Work?
All the muscles in the body give off small electrical signals that can be monitored with electromyography (EMG), the type of biofeedback most often used in the clinic. By placing small sensors close to the muscles being monitored, biofeedback devices detect and record this electrical activity. By “feeding back” the information gathered by the EMG to the patient, immediate knowledge about these muscles is available. This information can then be used to plan a personal exercise program to increase the strength and holding power of the muscles that control urination, defecation. Or, the exercise program can be planned to promote easier relaxation of the muscles if they are in a heightened state of contraction.
With biofeedback, the patient can learn to use the correct muscles during their exercises, and to stop using muscles that don’t assist in recovery.
Can Biofeedback Help Me?
In the case of weak muscles that are associated with stress urinary or fecal incontinence, patients are taught when and how to use the muscles correctly to control leakage of urine or feces. As the muscles grow stronger with exercise, people are more and more successful in preventing leakage.
For those with urge incontinence, the patient learns to use the muscles to quiet the sensation of urgency in order to get more time to reach the bathroom.
What can expect in a typical treatment session?
When you visit the office of the physical therapist, you will be asked about your complete health history and specifically about bladder and bowel problems. The physical therapist explains how the bladder and bowel work and uses models and pictures to show where the pelvic muscles are that help control these functions. Patients are usually asked to keep a diary so the patient, doctor, and physical therapist can learn when, how much and how often problems occur. The physical therapist will also teach the patient which foods and beverages may be affecting their bladder and bowel problems. A special toileting schedule may be suggested to help reestablish a more normal pattern of going to the bathroom. Also, better toilet positioning techniques may be suggested. Biofeedback may also be a part of treatment sessions.
How Long Does Treatment Take?
Each session lasts about an hour and it usually takes 3-8 treatments over a two-month period to see significant improvement. All patients are expected to practice at home what they are taught.
Is Treatment Covered By Medicare and Other Insurance?
Yes, Medicare and most private insurance carriers cover physical therapy, including treatment for incontinence and pelvic floor muscle dysfunctions.
- Are effective in the treatment of incontinence when used by trained physical therapists.
- Can be helpful in certain other conditions caused by pelvic muscle dysfunction.
- Are useful for people who are willing and able to assume more responsibility for control of their bodies.
- Can be used along with medications and other types of treatment for incontinence such as bladder/bowel training and dietary modification.
- May be prescribed and utilized before and after surgery.