Services - Biofeedback & Physical Therapy

Las Colinas ObGyn offers biofeedback and physical therapy for rehabilitation of the pelvic muscle.

Biofeedback has helped many people combat the ill effects from involuntary muscle tension and related pain.

Biofeedback requires intensive patient participation. The patient's goal is to learn to control involuntary functions such as heart rate, blood pressure, breathing, skin temperature, and muscle tension. The biofeedback therapist teaches the patient how to affect a particular function specific to a problem through mental or physical exercises (e.g. tense neck muscles).

Pelvic muscle rehabilitation (PMR) for patients with pelvic floor disorders combines the most effective non-surgical treatment modalities in an effort to restore normal tone and function to the muscles of the pelvic floor. PMR may provide an additional element of reflex bladder inhibility. PMR is based on the theory that all behaviors, including physiologic events, are a function of three interacting sets of factors:

• Antecedents of behavior which are stimuli or events that immediately precede behavior and function as cues.
• Consequences of behavior are stimuli or events that follow and will have a bearing on whether that particular behavior will occur again.
• Genetic predisposition.

Pelvic floor disorders can result from a deficit of antecedents or consequences. PMR treatment aims to improve continence by altering antecedent or consequent stimuli, or both. PMR is a planned treatment program with these key components:

1. EMG muscle evaluation.
2. Pelvic floor muscle exercise program.
3. Bladder retraining.
4. Alteration of lifestyle behavior.
5. Neuromuscular electric stimulation (adjunct therapy).

PMR is an effective, low-risk intervention that can reduce pelvic floor dysfunction significantly in varied populations and should be initially considered before other treatments. Many studies have demonstrated the effectiveness of pelvic floor muscle exercises (PFME). A systematic review of randomized controlled trials (RCT) on the conservative treatment of UI reveal strong evidence to support PFME as being effective in reducing the symptoms of stress, urge and mixed urinary incontinence. This corresponds well with the findings that vaginal and urethral pressures, as well as EMG readings correlate significantly with PFM contractions.

For PFME to be effective, a person must have:

• Ability to contract and isolate the correct muscles.
• Attend office visits as deemed necessary.
• Comply with a specific home exercise treatment program.

It is not possible to establish whether or not a patient will be able to perform an adequate pelvic muscle contraction merely by considering age, clinical severity, urethral support or urethral profilometry. Only by assessment through examination and an EMG evaluation can an exercise regimen be determined.