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Physical Therapy Definitions

Biofeedback

Biodfeedback is a procedure that utilizes electrical instrumentation to detect and measure the physiologic response of the pelvic floor muscles to various exercises. It helps facilitate the acquisition of a new skill and ensures that the exercises are performed optimally. Patients are able to "see" how much his/her muscles are working. Internal sensors are able to detect improvement in pelvic muscle strength far before changes in symptoms are identified; therefore, motivation stays high.

Muscle control training though biofeedback has been shown to be 85% effective in treating non-acute patients. Our clinic utilizes biofeedback for the following diagnoses.

  • Stress incontinence

  • Urge incontinence

  • Pre/post-partum incontinence

  • Chronic constipation

  • Fecal incontinence

  • Benign prostate hyperplasia/post-radical prostatectomy

  • Post bladder suspension surgery

    Biofeedback offers a viable alternative for those who are not good surgical candidates due to age or other factors. It is the most cost-effective treatment available and is covered by most insurance plans. Biofeedback/assisted muscle training gives patients more control of their treatment, and provides them with the knowledge by which they can work to maintain control of their bladder & bowel health.

    How does Biofeedback work?

    The treatment of urinary stress and urge incontinence through muscle control training is a simple procedure. The patient is taught a series of exercises called "Kegel-Exercises" (after the gynecologist who developed them in the 1940's), which are designed to strengthen the muscles which control the leakage of urine. The strengthening of these important muscles often either cures or lessens the problem of incontinence and may help avoid surgery or repeat surgery. Biofeedback is a procedure which speeds progress in learning the Kegel Exercises. It can also teach other ways to facilitate strengthening of the pelvic floor muscles, as well as ensure proper performance of the exercise.

    Pelvic Floor Dysfunction

    Affects majority of women and men with diagnoses of interstitial cystitis, overactive bladder, irritable bowel syndrome, and chronic pelvic pain. Pelvic floor dysfunction can include disorders of the urinary, genital, and colorectal systems.

    The pelvic floor is a group of postural support muscles that is situated at the base of the pelvis. If the pelvic cavity is viewed as a large container, the base of the container is the pelvic floor. The sides of the container is the lumbo-sacral spine and the abdomen. The roof is the diaphragm. The pelvic floor works as a group of muscles that assist with the proper support and function of the pelvic organs.

    The pelvic floor muscles attach to the ilium (hip bone), sacrum (tail bone), and the pelvic. Some patients with pelvic floor dysfunction have a malalignment of the sacroiliac joint which may contribute to their dysfunction.

    Sacroiliac Joint

    The sacrum and coccyx are the last group of bones that make up the spinal column. The sacrum lies between the two pelvic hip bones. The hip bones attach together in the front at the symphysis pubis. One of the primary functions of the sacroiliac joint is to serve as a sort of "shock absorber". It decreases the shearing and compressive forcees into the spine from the lower limbs contacting the ground.

    Sacroiliac Dysfunction

    In most instances the sacroiliac joint is a very stable joint, however, due to either trama or muscles imbalance, an abnormal position of the sacroiliac joint may be found. When this occurs, associated muscle spasm will occur in the muscles that attach to the pelvis including the pelvic floor muscles. When muscle spasm occurs over a long period of time the muscles will actually tighten. This is called a "high tone state" of the pelvic floor muscles. This high tone state makes it very difficult for the pelvis to return to its normal position. It may also lead to pinched internal nerves, as well as pelvic pain, dyspareunia (discomfort with intercourse), urinary frequency, urgency, and burning. Myofascial trigger points may also develop in the surrounding musculature.




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