On 5 November 2024, a team of researchers published the results of a multicentre randomised controlled clinical trial in the JAMA NETWORK OPEN journal, which compared the efficacy of home-based pelvic floor muscle exercises alone with biofeedback training using home-based wearable devices for postpartum urinary incontinence. The results showed a significant reduction in incontinence severity and a significant increase in cure rate, improvement rate, and pelvic floor muscle strength in patients with biofeedback training.
26% ~ 63% of women experience urinary incontinence for the first time during pregnancy and postpartum. Physician-guided pelvic floor muscle exercise is the first-line treatment option for stress incontinence or mixed incontinence with predominantly stress incontinence. Biofeedback training of the pelvic floor muscles can be used to assess the effectiveness of pelvic floor muscle training. A device with a built-in pressure sensor is placed in the patient's vagina during training, allowing the curve of the muscle contraction to be seen and feedback on the effectiveness of the training to be obtained. In recent years, biofeedback training has become more and more popular, including action-mediated, electromyography-mediated, pressure-mediated and sensory-mediated biofeedback, etc. It has become a common treatment item in pelvic floor rehabilitation centres of medical institutions, and a variety of wearable devices suitable for home use have appeared.
What kind of rehabilitation is more cost-effective for postpartum urinary incontinence patients? To answer this question, the research team led a randomised controlled trial initiated in March 2022 at five healthcare institutions. The study included 452 patients with postpartum urinary incontinence at an average age of 34 years, who were randomised into two groups, both of which underwent training for three months. The control group performed at-home pelvic floor muscle exercises under the supervision of a doctor; the intervention group used a wearable biofeedback trainer in conjunction with at-home pelvic floor muscle exercises, and data and images of the patients' training results were displayed and recorded in real time on a mobile phone app. The researchers assessed the patients before training, and 3, 6 and 12 months after training. The results showed that at the end of the 3-month intervention period, the incontinence score improvement was 2, cure rate 8.7%, improvement rate 44.5%, and pelvic floor muscle strength 21 cm water column in the control group, and incontinence score improvement was 3, cure rate 20.2%, improvement rate 59.2%, and pelvic floor muscle strength 26 cm water column in the intervention group. All indicators in the intervention group were better than those in the control group.
The head of this research team introduced that for patients, home rehabilitation training of pelvic floor muscles has outstanding advantages in terms of privacy and convenience. This study provides evidence to support the efficacy of home pelvic floor muscle exercise wearing biofeedback trainers. The group has embarked on further research to provide more scientific guidance and innovative solutions for home rehabilitation of patients to prevent and treat urinary incontinence and other diseases.
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