What is the pelvic floor and what happens when it weakens?
The pelvic floor is a group of muscles that stretch from the pubic bone to the tail bone which assists with bladder and bowel control and supports the bladder, bowel, and uterus. It is critical to health and quality of life to maintain the function of the pelvic floor and ensure the bladder and bowel can function normally. Pregnancy, birth, straining from consistent constipation, and treatment for prostate cancer can all lead to the weakening of the pelvic floor. A weak pelvic floor can cause symptoms such as incontinence (loss of bladder control) and/or constipation. Such conditions are serious problems that must be addressed with the best rehabilitation possible, but they often go un-discussed with healthcare professionals. Those who do bring them up with their doctors can decrease their symptoms with specialized physical therapy, which focuses on regaining proper pelvic floor muscle function. [2]
How does biofeedback help strengthen the pelvic floor?
Biofeedback can be used in the physical therapy for regaining strength in the pelvic floor. Sensors are placed on the abdomen and around the anal cavity to target the muscles used during urination and bowel movements. In biofeedback training, these sensors do not administer any current! They simply pick up on the muscle contraction produced by patients’ voluntary contractions.
The sensors connect to a visual display of the user’s contractions and relaxations. This feedback makes it possible to see the muscle contractions that are taking place; understanding this is critical to accurate performance in an area of the body that is often very difficult to target. By showing the user if he/she is contracting the pelvic floor muscles properly, both provider and patient can make adjustments and improve volitional control over time. Motivated patients know when their muscles are engaged properly and can constantly work toward that goal! Effortful, accurate repetition leads to muscle memory that will help patients engage these muscles in and outside of physical therapy.
With practice, the patient will recognize the correct way to engage the pelvic floor muscles and will see improvement in the incontinence and/or constipation. The consistent exercises will strengthen the pelvic floor to improve day-to-day symptoms and quality of life. With biofeedback, these exercises can also be performed at home, to increase the number of reps performed and ensure the patient is getting the most out of their rehabilitation. [1]
CASE STUDY: Biofeedback in treatment for constipation
A study was performed on 66 people that suffer from constipation as a result of vaginal birth or an orificial surgery (surgery related to vagina, anus, or urethra). The members of this study completed between 4 and 29 sessions of biofeedback where they relaxed and contracted the pelvic floor muscles necessary for defecation. Electrodes were placed above and below the anus. One group contracted for 40 seconds and relaxed for 8 seconds. The second group did the same but added 2 seconds of contraction and 5 seconds of relaxation for 10 repetitions.
The results of this experiment “confirm that biofeedback was effective in the treatment of constipation and associated pelvic floor disorders, such as soiling.” [3]
Check out our references below for articles featuring biofeedback for urinary incontinence and other conditions!
mTrigger is currently developing custom sensors for pelvic health applications that will serve this market of patients to help them improve their quality of life by utilizing an affordable mobile biofeedback intervention.
References
[1] Biofeedback. (n.d.). Retrieved November 02, 2020, from http://www.pelvicfloorcenter.org/content/biofeedback
[2] Pelvic Floor First. (n.d.). Retrieved November 02, 2020, from http://www.pelvicfloorfirst.org.au/pages/the-pelvic-floor.html
[3] M. (2006). Pelvic floor exercises with biofeedback for stress urinary incontinence. Retrieved November 4, 2020, from https://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382006000400015&lng=en&tlng=en
[4] Pelvic floor exercises with biofeedback for stress urinary incontinence: https://pubmed.ncbi.nlm.nih.gov/16953917/
[5] Biofeedback for Pelvic Floor Muscle Re-education from Cleveland Clinic: https://my.clevelandclinic.org/ccf/media/files/Digestive_Disease/woc-spring-symposium-2013/biofeedback-for-pelvic-floor-muscle-reeducation.pdf
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