"This review indicates that judiciously used multi-component instrumental feedback provides the optimal condition in which to teach pelvic muscle or Kegel exercises. It seems there is a graded, or additive effect when biofeedback is added to the training protocol as was demonstrated by Burgio and colleagues."
[Source: J. Tries. "Kegel Exercises Enhanced by Biofeedback." J. Enterostomal Therapy, 17:2, p. 67-76 (Mar 1990)]
"...biofeedback therapy with a vaginal probe ([PerryMeterŞ] perineometer) helps patients identify the muscle, provides immediate feedback and assists the nurse and patient..."
[Source: P.A. Burns, M.A. Marecki, S.S. Dittmar, B. Bullough. "Kegel's Exercises with Biofeedback Therapy for Treatment of Stress Incontinence" Nurse Practitioner, February, 1985, p. 28ff.] [First published study using PerryMeterŞ EMG perineometer sensors.]
"There was a 100% continence rate in Experimental Group 1 using daily biofeedback at home during Kegel exercises. Overall, the continence level achieved by the control group was 67%..."
[Source: K. Taylor and J. Henderson, "Effects of Biofeedback and Urinary Stress Incontinence in Older Women", J. Geront Nursing, 12:9, p. 25-30 (1986)] [First published study of effectiveness of PerryMeter home trainers.]
"Burgio stated emphatically that the most important aspect of the pelvic floor exercise program was biofeedback. Kegel exercises were found to be effective, but electric stimulation had no additional effect. Awareness training of the (PC) muscle and use of a biofeedback device such as a perineometer were the major factors for successful treatment outcomes."
[Source: H. Herman, "Urogenital Dysfunction." Chap. 4 in Obstetric and Gynecologic Physical Therapy, p. 83-111]
"Then in 1975, Dr. John Perry of Pennsylvania invented a new type of perineometer - one that detects muscle activity directly instead of through pressure. This results in a more accurate measurement. He pioneered the resurgence of interest in this treatment."
[Source: Dr. Jeff Nicols, describing the Menninger Clinic's new urinary and fecal incontinence program using Perry's software and EMG sensors. Quoted in V. G. Hawver, "Health: Biofeedback for bladder control; Incontinence remains taboo topic", The Topeka Capital-Journal, Feb. 10, 1990.]
"We concluded that simple verbal or written instruction does not represent adequate preparation for a patient who is about to start a Kegel exercise program."
[Source: R.C. Bump, W. G. Hurt, J.A. Fantl, J.F. Wyman. "Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction." Am J Obstet Gynecol 1991; 165:322-9]
"I think the worst way to instruct patients is to ask them to interrupt the urinary stream repeatedly during micturition."
[Source: R. C. Bump, "Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction." Am J Obstet Gynecol 1991; 165:322-9]
"Our study showed a 20% increase in the average number of incontinent episodes. ...We conclude that electrical stimulation (using the Microgyn II device) is not effective by itself in improving urinary incontinence in functionally impaired nursing home patients. In fact, there was a tendency for electrical stimulation to worsen incontinence."
[Source: P. Lamhut, T.W. Jackson, L.L. Wall. "The Treatment of Urinary Incontinence with Electrical Stimulation in Nursing Home Patients: A Pilot Study" J Am Geriatric Soc 40:48-52 January, 1992.]
"As a general rule, the least invasive therapy that is appropriate should be used first. That would mean, in many cases, behavioral and pharmacological treatments are tried first."
[Source: Dr. Ananias C. Diokno, chair of AHCPR Panel on Incontinence, quoted at Press Conference, The New York Times, March 24, 1992.]
"The [AHCPR] guidelines suggest treatment should begin with the least invasive therapies: medication, bladder retraining and pelvic muscle exercises."
[Source: "Medical Panel Issues New Set of Guidelines." Wall Street Journal, March 24, 1992.]
"The panel...recommends noninvasive therapy-bladder training, pelvic muscle exercises, and treatment of transient causes of incontinence such as underlying infection-for most cases of UI."
[Source: "New guideline on urinary incontinence released." Research Activities: Agency for Health Care Policy and Research, No. 152, April, 1992, p. 1.]
"...the non-binding guideline, to be issued March 23 by the U.S. Agency for Health Care Policy and Research, calls for doctors generally to use surgery as a last resort. It emphasizes informing patients about and using the full range of treatment options, including bladder retraining, pelvic muscle exercises and medication."
[Source: Harris Meyer, "U.S. issues guideline on adult urinary incontinence", American Medical News, March, 1992.]
"The guideline recommends that surgery, except in very specific cases, should be considered only after behavioral and pharmacologic interventions have been tried. The panel outlines several surgical options and their risks for particular UI problems."
[Source: AHCPR, Guidelines on Urinary Incontinence in Adults, (AHCPR, Rockville, MD, March 23, 1992), First Edition ONLY, p. xii. {As distributed to Members of Congress and to the Press. These two sentences were later deleted from the edition circulated to the general public.}]