Enhancing self-efficacy and pelvic floor muscle exercise adherence through sEMG biofeedback : a randomised study

Hallam, SM

Abstract

Background Pelvic floor muscle exercises are a recommended first-line
treatment for stress urinary incontinence (SUI) in women (NICE, 2006). Poor
adherence to pelvic floor muscle exercises (PFME) is a recognised problem
which has the potential to compromise successful treatment (Bø, 1995;
Alewijnse et al., 2001). Biofeedback is thought to help motivate PFME
practice but so far this has not been evaluated in a randomised study.
Aim This study tests the hypothesis that use of clinic-based sEMG
biofeedback improves women’s motivation to exercise (PFME adherence) by
increasing pelvic floor muscle exercise self-efficacy, an important construct in
pelvic floor muscle exercise adherence behaviour.
Method After ensuring that they are able to make an informed decision to
participate, a sample of sixty women referred for physiotherapy treatment of
SUI between December 2008 and February 2010, gave consent to participate
in the study. They were randomised into one of two groups. Thirty one
women received clinic-based sEMG biofeedback in addition to the usual care,
twenty nine received the usual care. Each participant attended clinic twice in a
three month treatment period. Women were also asked to adhere to a daily
home exercise programme (HEP). The primary outcome was pelvic floor
muscle exercise self-efficacy. PFME self-efficacy and HEP adherence, were
assessed by means of self-completed questionnaires.
Results Ten women dropped out of the study before completion. Both
groups improved on all outcomes, but no significant difference was found
between the groups in terms of self-efficacy levels or exercise adherence
rates. PFME recall was more accurate in the intervention group receiving
clinic-based sEMG biofeedback. A positive and significant relationship was
confirmed between PFME self-efficacy and PFME adherence. These findings
are discussed in respect to the concept of self-efficacy and behavioural
change.
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Conclusion In the short term, clinic-based sEMG biofeedback does not
increase PFME self-efficacy or HEP practice beyond that achieved through
instruction using vaginal palpation. These findings refute the belief that
monitoring with sEMG biofeedback improves self-efficacy or women’s
motivation to adhere to a HEP, but does suggest that biofeedback may be a
useful adjunct to teaching PFME.

Citation

Hallam, S. Enhancing self-efficacy and pelvic floor muscle exercise adherence through sEMG biofeedback : a randomised study. (Thesis). University of Salford

• Thesis Type: Thesis
• Deposit Date: Dec 17, 2014
• Publicly Available Date: Dec 17, 2014