Clinical Efficacy of Supervised Pelvic Floor Muscle Training - assisted Biofeedback on Quality of Life and Functional Outcomes in patients with Fecal Incontinence

Background: Fecal incontinence (FI) is a prevalent, and embarrassing condition that drastically affects the quality of life (QOL). Pelvic floor muscle training (PFMT) is the first-line therapy in FI either alone or combined with biofeedback (BF). Little trials investigated the effectiveness of PFMT together with BF in improving FI and QOL Aim: To investigate the efficacy of supervised PFMT -assisted BF in improving FI, quality of life, and strength of the rectal muscle in adults with FI. Methods: A quasi‑experimental design was conducted on 60 patients with FI attending the gastrointestinal motility unit affiliated to gastroenterology center Mansoura University Hospitals and referred for biofeedback and Pelvic Floor exercise. The Fecal Incontinence Quality of Life Questionnaire and the Cleveland Clinic Florida Fecal Incontinence scale were filled out at the first visit and then at follow-up after six months. The patients were directed to perform daily pelvic floor exercise at home. Data were analyzed using SPSS (version 20). Results: There was a significant improvement in fecal incontinence severity and quality of life domains post 8-sessions of PFMT -assisted BF P<0.001. A strong negative correlation was found between fecal incontinence severity and improvement in fecal incontinence quality of life. Strong positive correlation existed between improvements in quality-of-life domains. Conclusion: PFMT-assisted BF has proven to be an effective method for improving FI, QOL, and increasing the strength of the anal sphincter. Relevance to clinical practice: PFMT-assisted BF can be recommended as a safe, painless approach and a key element in the comprehensive management of patients with FI. It should be considered as a feasible option by healthcare providers.