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

Hallam, SM 2012, Enhancing self-efficacy and pelvic floor muscle exercise adherence through sEMG biofeedback: a randomised study , DProf thesis, University of Salford.

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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. xi xii 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.

Item Type: Thesis (DProf)
Depositing User: S Rafiq
Date Deposited: 17 Dec 2014 13:14
Last Modified: 30 Nov 2015 23:44

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