Biofeedback

Biofeedback is a generalized term that describes the use of some verbal, electronic or visual clue to assist in the learning of body control.

Examples include use of visual representations of blood pressure measurement or breathing pattern to assist with relaxation.

In our field, biofeedback loosely refers to pelvic floor physiotherapy or monitored Kegel exercises.  Isolated contraction of the levator muscles is extremely difficult and requires tremendous concentration and coordination.  Having a probe monitoring the electrical activity of the muscles in the pelvis and showing this as a curve on a computer monitor can help a patient focus on the exercise and know that the exercise is being performed properly.

The reasons for this are somewhat obvious as there is strengthening of the muscles that can support the bladder neck and urethra with increases in intraabdominal pressure hopefully preventing a leakage episode.  But the benefit goes beyond the simple muscle training.  There are physicians who believe that this repetitive exercise acts to develop neurologic memory of a novel and appropriate pelvic neural pathway.  This is important as there is increasing evidence that much voiding dysfunction and incontinence of urine and stool is secondary to neural discoordination.  Biofeedback is usually performed on a weekly basis for one hour with a nurse or technician in attendance.  Either an anorectal or vaginal probe is used to monitor the pelvic muscle activity.  Usually the patient is given homework which generally consists of specific muscular exercises that are to be practiced during the ensuing week.