Biofeedback is a teaching technique where people are taught to improve their health by using signals from their own body. People use biofeedback on a regular basis but don’t even realize it. For example, both the bathroom scale and a thermometer are feedback devices that provide information about the body’s condition. People who see they weigh too much can cut their intake of fat calories and increase their exercise, and people who find they have a temperature above 98.6o  on their thermometer can treat their condition by drinking more fluids and consulting a doctor to reduce their fever. Nurses, physical therapists and other health professionals use very sensitive biofeedback instruments to provide immediate information to patients about their bodily functions. Biofeedback has been used for patients with migraine headaches to lower blood pressure, and for pain control.

Now, biofeedback is being used in the treatment of bladder control problems. One type of biofeedback is called EMG, or electromyography. All muscles in the body give off electrical signs that can be measured with EMG. For people with urinary incontinence, EMG biofeedback can supply information about the state of the muscles of the pelvic floor that help control urination. Most people are unaware of these muscles. Biofeedback is an important tool which can help patients understand how to use these muscles properly.

How does it work? Special sensors are placed near the pelvic muscles that help in controlling urination. The sensors resemble either a tampon for the vagina or a suppository for the anus.  The patient can usually place the vaginal or anal sensor without help. Another set of sensors, called electrodes, are placed on the abdomen. Once the sensors are in place, the biofeedback therapist connects the sensors to a computer. The computer changes this information into a signal that can be seen on the computer screen in the form of lines and bars. The information the patient receives from the signal can then be used to make adjustments in muscle activity.  The job of the biofeedback therapist is to coach the patient in the proper use of the pelvic muscles. By doing what the therapist asks (i.e., “squeeze or relax”), patients will see the signal on the screen changing as they make changes in their body to contract and relax the muscles.

As these changes occur, patients become more aware of the pelvic muscles and eventually learn to use the muscles without having to depend on biofeedback.

Biofeedback has been effective in the treatment of incontinence when used by trained and experienced therapists. It is useful for people who are willing and able to assume more responsibility and control of their body. Biofeedback does nothing to patients. It assists them in learning to control their own body. There are no side effects. And, biofeedback can be used along with medications and other types of treatment for incontinence. It may be prescribed before and after surgery, should an operation become necessary.

Barbara F. Woolner, RN, CRNA, BS
Katherine F. Jeter, EdD, ET

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