2.5. Biofeedback therapy18
Manometric BF-assisted PFMT was performed two times weekly to females in the intervention group only using Myomed 632® equipment, Enraf Nonius, Delft, and the Netherlands). Menstruating females were temporarily withdrawn from BF sessions till end of the menses. In females presenting with SUI, vaginal pressure sensor was used for BF training while in those with FI, rectal pressure sensor was used. Self-application of sensors was practiced by females with the same above mentioned procedure in the baseline assessment of vaginal manometric pressure measurements. In BF training, visual and auditory feedbacks were provided to stimulate their correct performance in addition to positive verbal reinforcement which was provided by the investigator to encourage learning of the abdomino-pelvic muscular coordination. Getting the right technique of PFM contraction was only the beginning of BF-assisted PFMT program which included individually designed and supervised sessions which were based on the DTPFMC evaluated at the beginning of each BF session to be used as the working period where the female was highly motivated to increase DTPFMC, depending on the female’s ability and to rest four seconds in between contractions. These work/rest cycles were repeated several times during the session where females were also encouraged to practice endurance training and flicks exercises several times for up to forty-five minutes which is considered as the total time committed to BF session. The time spent on BF session was dependent on the female’s response, for example when PFM contractions began to show fatigue, or the female began to compensate with abdominal muscles, it was time to end the session.
2.5 biofeedback therapy18Manometric BF-assisted PFMT was performed two times weekly to females in the intervention group only using Myomed 632® equipment, Enraf Nonius, Delft, and the Netherlands). Menstruating females were temporarily withdrawn from BF sessions till end of the menses. In females presenting with SUI, vaginal pressure sensor was used for BF training while in those with FI, rectal pressure sensor was used. Self-application of sensors was practiced by females with the same above mentioned procedure in the baseline assessment of vaginal manometric pressure measurements. In BF training, visual and auditory feedbacks were provided to stimulate their correct performance in addition to positive verbal reinforcement which was provided by the investigator to encourage learning of the abdomino-pelvic muscular coordination. Getting the right technique of PFM contraction was only the beginning of BF-assisted PFMT program which included individually designed and supervised sessions which were based on the DTPFMC evaluated at the beginning of each BF session to be used as the working period where the female was highly motivated to increase DTPFMC, depending on the female’s ability and to rest four seconds in between contractions. These work/rest cycles were repeated several times during the session where females were also encouraged to practice endurance training and flicks exercises several times for up to forty-five minutes which is considered as the total time committed to BF session. The time spent on BF session was dependent on the female’s response, for example when PFM contractions began to show fatigue, or the female began to compensate with abdominal muscles, it was time to end the session.
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