Randomized Controlled Trial of Biofeedback for Fecal Incontinence
Authors: Norton, C., Chelvanayagam, S., Wilson-Barnett, J., Redfern, S. and Kamm, M.A.
Journal: Gastroenterology
Volume: 125
Issue: 5
Pages: 1320-1329
ISSN: 0016-5085
DOI: 10.1016/j.gastro.2003.09.039
Abstract:Background & Aims: Behavioral treatment (biofeedback) has been reported to improve fecal incontinence but has not been compared with standard care. Methods: A total of 171 patients with fecal incontinence were randomized to I of 4 groups: (1) standard care (advice); (2) advice plus instruction on sphincter exercises; (3) hospital-based computer-assisted sphincter pressure biofeedback; and (4) hospital biofeedback plus the use of a home electromyelogram biofeedback device. Outcome measures included diary, symptom questionnaire, continence score, patient's rating of change, quality of life (short-form 36 and disease specific), psychologic status (Hospital Anxiety and Depression scale), and anal manometry. Results: Biofeedback yielded no greater benefit than standard care with advice (53% improved in group 3 vs. 54% in group 1). There was no difference between the groups on any of the following measures: episodes of incontinence decreased from a median of 2 to 0 per week (P < 0.001). Continence score (worst = 20) decreased from a median of 11 to 8 (P < 0.001). Disease-specific quality of life, short-form 36 (vitality, social functioning, and mental health), and Hospital Anxiety and Depression scale all significantly improved. Patients improved resting, squeeze, and sustained squeeze pressures (all P < 0.002). These improvements were largely maintained I year after finishing treatment. Conclusions: Conservative therapy for fecal incontinence improves continence, quality of life, psychologic well-being, and anal sphincter function. Benefit is maintained in the medium term. Neither pelvic floor exercises nor biofeedback was superior to standard care supplemented by advice and education.
Source: Scopus
Randomized controlled trial of biofeedback for fecal incontinence.
Authors: Norton, C., Chelvanayagam, S., Wilson-Barnett, J., Redfern, S. and Kamm, M.A.
Journal: Gastroenterology
Volume: 125
Issue: 5
Pages: 1320-1329
ISSN: 0016-5085
DOI: 10.1016/j.gastro.2003.09.039
Abstract:BACKGROUND & AIMS: Behavioral treatment (biofeedback) has been reported to improve fecal incontinence but has not been compared with standard care. METHODS: A total of 171 patients with fecal incontinence were randomized to 1 of 4 groups: (1) standard care (advice); (2) advice plus instruction on sphincter exercises; (3) hospital-based computer-assisted sphincter pressure biofeedback; and (4) hospital biofeedback plus the use of a home electromyelogram biofeedback device. Outcome measures included diary, symptom questionnaire, continence score, patient's rating of change, quality of life (short-form 36 and disease specific), psychologic status (Hospital Anxiety and Depression scale), and anal manometry. RESULTS: Biofeedback yielded no greater benefit than standard care with advice (53% improved in group 3 vs. 54% in group 1). There was no difference between the groups on any of the following measures: episodes of incontinence decreased from a median of 2 to 0 per week (P < 0.001). Continence score (worst = 20) decreased from a median of 11 to 8 (P < 0.001). Disease-specific quality of life, short-form 36 (vitality, social functioning, and mental health), and Hospital Anxiety and Depression scale all significantly improved. Patients improved resting, squeeze, and sustained squeeze pressures (all P < 0.002). These improvements were largely maintained 1 year after finishing treatment. CONCLUSIONS: Conservative therapy for fecal incontinence improves continence, quality of life, psychologic well-being, and anal sphincter function. Benefit is maintained in the medium term. Neither pelvic floor exercises nor biofeedback was superior to standard care supplemented by advice and education.
Source: PubMed
Preferred by: Sonya Chelvanayagam
Randomized controlled trial of biofeedback for fecal incontinence
Authors: Norton, C., Chelvanayagam, S., Wilson-Barnett, J., Redfern, S. and Kamm, M.A.
Journal: GASTROENTEROLOGY
Volume: 125
Issue: 5
Pages: 1320-1329
eISSN: 1528-0012
ISSN: 0016-5085
DOI: 10.1016/j.gastro.2003.09.039
Source: Web of Science (Lite)
Randomized controlled trial of biofeedback for fecal incontinence.
Authors: Norton, C., Chelvanayagam, S., Wilson-Barnett, J., Redfern, S. and Kamm, M.A.
Journal: Gastroenterology
Volume: 125
Issue: 5
Pages: 1320-1329
eISSN: 1528-0012
ISSN: 0016-5085
DOI: 10.1016/j.gastro.2003.09.039
Abstract:Background & aims
Behavioral treatment (biofeedback) has been reported to improve fecal incontinence but has not been compared with standard care.Methods
A total of 171 patients with fecal incontinence were randomized to 1 of 4 groups: (1) standard care (advice); (2) advice plus instruction on sphincter exercises; (3) hospital-based computer-assisted sphincter pressure biofeedback; and (4) hospital biofeedback plus the use of a home electromyelogram biofeedback device. Outcome measures included diary, symptom questionnaire, continence score, patient's rating of change, quality of life (short-form 36 and disease specific), psychologic status (Hospital Anxiety and Depression scale), and anal manometry.Results
Biofeedback yielded no greater benefit than standard care with advice (53% improved in group 3 vs. 54% in group 1). There was no difference between the groups on any of the following measures: episodes of incontinence decreased from a median of 2 to 0 per week (P < 0.001). Continence score (worst = 20) decreased from a median of 11 to 8 (P < 0.001). Disease-specific quality of life, short-form 36 (vitality, social functioning, and mental health), and Hospital Anxiety and Depression scale all significantly improved. Patients improved resting, squeeze, and sustained squeeze pressures (all P < 0.002). These improvements were largely maintained 1 year after finishing treatment.Conclusions
Conservative therapy for fecal incontinence improves continence, quality of life, psychologic well-being, and anal sphincter function. Benefit is maintained in the medium term. Neither pelvic floor exercises nor biofeedback was superior to standard care supplemented by advice and education.Source: Europe PubMed Central