Technology and Pelvic Floor Dysfunction
Bridget Coley PT, MSc. BKin
Pelvic Floor Dysfunction (PFD) refers to a broad spectrum of symptoms related to abnormal function of the pelvic floor muscles. PFD can be caused by a wide variety of factors or combinations of factors. Generally, it is correlated with overactivity (hypertonic), decreased activity (hypotonic), or inappropriate coordination of the muscles. It can also involve changes in the support of the pelvic organs such as in the case of a pelvic organ prolapse. Symptoms of PFD can include: Urinary or fecal incontinence, dyspareunia (pain during intercourse), urinary retention, constipation, and pelvic pain.
Pelvic Floor Muscle Training
Guidelines recommend Pelvic Floor Muscle Training (PFMT) as a first line conservative treatment to help with Pelvic Floor Dysfunction. While PFMT has historically been prescribed by pelvic health physiotherapists, pelvic floor devices have been developed to help assist in PFMT or to be used as an alternative. One type of pelvic floor device is a biofeedback device. Biofeedback devices are internal devices that use sensors to take measurements which display pelvic floor muscle activity which can be used to assist in pelvic floor muscle training. While not a foolproof solution, people have experienced benefits stemming from the ability to quantify their pelvic floor muscle activity.
Two popular biofeedback devices on the market are the Elvie Trainer and Perifit. Both of these tools are internal devices made of medical grade silicone and are used by inserting the sensing component into the vagina. Pelvic floor muscle activity is then measured and displayed to you live on your mobile device using their supporting apps. They allow you to visualize the speed, endurance, and relaxation of your pelvic floor muscles in real time. They are designed for aiding in strengthening of the pelvic floor muscles, however they are not a substitute for treatment by a pelvic health physiotherapist.
The Pros:
Motivation: some people find it more motivating to be able to visually see how they are doing;
Entertainment: The Elvie Trainer and Perifit biofeedback devices come with games that turn pelvic floor muscle training into a fun activity;
Live feedback: these devices provide visual feedback around how you are performing your kegels which help ensure exercises are being done properly;
Privacy: they can be used within the comfort of your own home.
The Cons:
Labour-intensive: Setup is time intensive. Users have to physically insert the devices, clean before and after use, and require a more private location to use;
Accuracy: Even if you have great stats on the app and in the game, you may be compensating using other muscles (bracing abdominals, squeezing glutes and thighs). However, some devices such as the Elvie Trainer claim to be designed to inform users when exercises are being performed incorrectly;
Pressure-dependent: Unable to assess resting tension/tone in the pelvic floor muscles. This is not necessarily helpful for users needing to focus on a pelvic floor relaxation program.
It should be noted that these devices cannot replace a pelvic floor assessment by an experienced pelvic health physiotherapist. Biofeedback devices do not report on the resting or relaxed state of the pelvic floor muscles, which a pelvic health physiotherapist would take into consideration as part of their assessment. Devices also do not give education or context as to why a user might be seeing the results that they see, and can lead to the wrong idea about an individual’s pelvic health. A proper internal exam can help determine if Pelvic Floor Dysfunction stems from a pelvic floor that is overactive or weak, which helps determine what treatment and/or therapeutic exercises would be beneficial. Our pelvic exams also give us information on the state of the tissues that make up the pelvic floor, such as whether a biofeedback device is a viable option or whether a different treatment strategy should be considered based on assessed tissue health.
However, biofeedback can be a great tool when used as an adjunctive therapy to help with motivation, consistency, and monitoring, particularly when working on strengthening the pelvic floor muscles. If you want to learn more about biofeedback devices or are struggling with any symptoms, book an appointment with one of our pelvic health physiotherapists today.
Resources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6852158/