In women with urinary incontinence the effects of pelvic floor muscle training with biofeedback and of magnetic chair on incontinence and quality of life

ABSTRACT IN WOMEN WITH URINARY INCONTINENCE THE EFFECTS OF PELVIC FLOOR MUSCLE EXERCISE WITH BIOFEEDBACK AND OF MAGNETIC CHAIR ON INCONTINENCE AND QUALITY OF LIFE This research was planned as a pretest-posttest test, randomized controlled experimental study to examine the effects of extracorporeal magnetic innervations and PFMT taught to women with stress-incontinence by EMG-BF, on the stress-urinary incontinence, sexual function and quality of life. The study population of the research is composed of (n=86) patients diagnosed with stress-urinary incontinence in Urology Polyclinic of Ege University Hospital between September 2015 and September 2016. The sampling of research comprised of 70 patients that diagnosed with stress-urinary incontinence in Urology Polyclinic of Ege University Hospital between September 2015 and 2016 and complied with the research criteria. At the first encounter all patients signed the informed consent form, the case report form, I-QQL and FSFI were filled out voluntarily; in addition, Q-type test, residue urinary volume, one-hour pad test were applied; after muscle strength was measured through perineometer and modified oxford scale information related to three-day bladder diary was provided and they were discharged home to apply it. Patients were randomized into two groups; both groups were given information through training booklet, they were requested to apply these exercises at home and note them on the "pelvic floor muscle exercise follow-up form". First group received 20-minute EMG BF-PFMT application twice a week for six weeks; second group received 20-minute EMG BF-PFMT application followed by 20-minute Extracorporeal Magnetic Innervation application twice a week for six weeks. At week eight, the I-QQL and FSFI were filled out; Q-type test, residue urinary volume, one-hour pad test were applied; measurement of perineometer and modified oxford scale and the three-day bladder diary applications repeated. Analysis of the research data was performed using SPSS package program version 15.0. During evaluation of data the following tools were utilized; frequency, percentage, number, average, standard deviation, minimal-maximal values and demographic variables for the homogeneity test between study and control groups; the chi-square and t-test during comparison of other quantitative-qualitative data and the variance analysis during repetitive measurements in intergroup comparisons. The variables that did not demonstrate normal dispersion was scrutinized through Brunner-Langer model (nonparametric analysis technique). Strength analysis was carried out in order to determine the sampling number and to reveal the strength of research. Results were evaluated at 95 % confidence interval and p<0.05 significance level. The mean age of BF group was determined as 51.539.00 years (min:38-max:69 years); BF + Magnetic chair group's as 50.288.89 years (min:30-max:66 years). It was identified that 42.3 % of patients in BF group were elementary school graduates, 24 % high school graduates, 65.4% were unemployed, 61.5 % had income equal to expenses, 73.1 % were living in down-town, whereas in BF+MS group, 24 % of patients were elementary school graduates, 44% were employed, 52 % had income less than expenses, 64 % were living in down-town. When the mean scores obtained by patients from I-QQL and FSFI and the groups were compared a significant difference was found between measurements in terms of pre-and post-application score averages. Measurements and group interactions were found statistically insignificant. A significant difference could not be detected between groups in terms of score averages concerning pre-and post-application incontinence quality of life scale. When patients' modified oxford scale and perineometer median values were compared with groups a significant difference was found between pre-and post-application measurements. Measurements and group interactions were statistically insignificant. Any significant difference could not be found between groups before and after application. When patients' Q-type test, residual urinary volume, pad test, number of urination, number of urinary incontinence median values were compared with groups, a significant difference was detected between pre- and post-application measurements. Measurements and group interactions were statistically insignificant. Any significant difference could not be detected between groups before and after application. When the groups are compared according to the median values of the patients' pad test and the number of urinary incontinence, a significant difference between pre- and post-application measurements, the higher rate of decrease in median values of BF+MS group and similar decrease rates in the median values of pre- and post-application measurments in both groups were found. It was concluded that application of PFMT with EMG BF for 20 minutes twice-weekly for 8 weeks improved women's quality of life and sexual functions and decreased incontinence complaints; however, using magnetic innervations in addition to PFMT with EMG BF had no additional effect on the quality of life, sexual functions and incontinence complaints. Key Words: Urinary Incontinence; Biofeedback; Magnetic Chair; Quality of Life; Sexual Function