Single-blind, randomized trial of pelvic floor muscle training, biofeedback-assisted pelvic floor muscle training, and electrical stimulation in the management of overactive bladder

OBJECTIVES: To compare the efficacy of pelvic floor muscle training (PFMT), biofeedback-assisted PFMT (BAPFMT), and electrical stimulation (ES) in the management of overactive bladder (OAB). METHODS: The interventions for the 12-week treatment period, conducted by the physiotherapist who was unaware of the progress and outcome, included (a) a PFMT program tailored to the subject's PERFECT (power, endurance, repetitions, and fast [1-second] contractions, with every contraction timed) scheme, used for training at home; (b) an electromyography BAPFMT program and home program tailored to the subject's PERFECT scheme; and (c) an ES program using biphasic symmetric probe current with 10-Hz frequency, 400-micros pulse width, 10/5 duty cycle, and varying intensity. Identical preintervention and postintervention assessment included King's Health Questionnaire, as well as outcomes of urge incontinence and other urinary symptoms. RESULTS: Of the 103 women who completed this study, 34 were in the PFMT group, 34 in the BAPFMT group, and 35 in the ES group. The changes in the three parameters of King's Health Questionnaire revealed statistically significant differences, except for the total score, between ES and BAPFMT (domain 7, P = 0.003; domain 9, P = 0.029; and total score, P = 0.952). These same parameters were significantly different between ES and PFMT (domain 7, P = 0.007; domain 9, P = 0.001; and total score P = 0.004). The change in total score was significantly different between BAPFMT and PFMT (P = 0.003). The subjective improvement/cure rate of OAB was 51.4% for ES, 50.0% for BAPFMT, and 38.2% for PFMT (P = 0.567). CONCLUSIONS: ES had the greatest subjective reduction rate of OAB and was the most effective of the three treatments. BAPFMT was more effective than PFMT.