OBJECTIVE: To evaluate the efficacy of shockwave therapy, acupuncture, hyperthermia, biofeedback therapy, electrical nerve stimulation, magnetotherapy and ultrasound therapy in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS), and to provide evidence-based support for clinical decision-making. METHODS: Two researchers independently searched PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP and Chinese Biomedical Literature databases for randomized controlled trials(RCTs) on the effects of different interventions on CP/CPPS from the establishment of the databases to August 2024. We evaluated the quality of the included literature and extracted the relevant data according to the Cochrane Handbook for Systematic Reviews of Interventions, followed by network meta-analysis using Revman 5.3, R 4.33 and Stata17 software. RESULTS: A total of 25 RCTs involving 1 794 cases were included. The results of network meta-analysis showed that electrical nerve stimulation, shockwave therapy, biofeedback therapy, magnetotherapy, ultrasound therapy and acupuncture were significantly superior to conventional medication and placebo in the total NIH-CPSI scores(P< 0.05), and so were electrical nerve stimulation and shockwave therapy to acupuncture and hyperthermia(P< 0.05), magnetic therapy to hyperthermia, and ultrasound therapy to placebo(P< 0.05). Shockwave therapy, biofeedback therapy, electrical nerve stimulation, magnetotherapy and ultrasound therapy achieved remarkably better clinical efficacy than conventional medication and placebo in the treatment of CP/CPPS, and so did shockwave therapy than electrical nerve stimulation, hyperthermia, ultrasonic therapy, magnetotherapy and acupuncture. CONCLUSION For the treatment of CP/CPPS, electrical nerve stimulation is advantageous over the other interventions in improving total NIH-CPSI scores, and shockwave therapy is advantageous in relieving pain symptoms and clinical efficacy. This conclusion, however, needs to be further verified by more high-quality clinical studies.
Humans ; Acupuncture Therapy ; Biofeedback, Psychology ; Chronic Disease ; Electric Stimulation Therapy ; Extracorporeal Shockwave Therapy ; Magnetic Field Therapy ; Pelvic Pain/therapy* ; Prostatitis/therapy* ; Randomized Controlled Trials as Topic ; Ultrasonic Therapy

OBJECTIVES: Stress urinary incontinence (SUI) is a common condition among women that severely impairs quality of life. Pelvic floor proprioceptive training (PFPT) has attracted increasing attention for its potential to enhance pelvic floor muscle function and alleviate SUI symptoms. This study aims to observe and compare the clinical efficacy of PFPT combined with electroacupuncture, electrical stimulation, and biofeedback therapy versus conventional therapy consisting of electroacupuncture, electrical stimulation, and biofeedback alone in women with SUI, and to explore the role of PFPT in improving symptom and functional outcomes. METHODS: In this randomized controlled trial, 72 women with mild to moderate SUI were recruited from the Department of Rehabilitation Medicine at Third Xiangya Hospital, Central South University, between December 2021 and October 2023. Participants were randomly assigned to an experimental group (n=36) or a control group (n=36). Both groups received health education. The control group underwent electroacupuncture combined with electrical stimulation and biofeedback therapy, while the experimental group additionally received PFPT 3 times per week for 4 weeks. The primary outcome was assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Secondary outcomes included pelvic floor muscle strength, bladder neck mobility, and balance ability. The ICIQ-SF was reassessed at 1, 3, 6, and 12 months post-treatment. RESULTS: Both groups showed statistically significant improvements in all parameters after treatment (all P<0.05). However, there were no statistically significant differences between groups in most measures (all P>0.05). The experimental group demonstrated longer single-leg stance duration with eyes closed than the control group (left leg: P=0.026; right leg: P=0.006), with a significant increase from baseline (P<0.001). At 6 months post-treatment, the cure rate in the experimental group was significantly higher than that in the control group (P=0.037). CONCLUSIONS Conventional therapy effectively improves SUI symptoms, but adding PFPT provides notable additional benefits, including enhanced balance ability and sustained mid-term cure rates. These findings suggest that PFPT is a valuable adjunct to standard SUI management strategies.
Humans ; Female ; Urinary Incontinence, Stress/physiopathology* ; Pelvic Floor/physiopathology* ; Middle Aged ; Biofeedback, Psychology ; Adult ; Exercise Therapy/methods* ; Proprioception ; Electroacupuncture/methods* ; Quality of Life ; Electric Stimulation Therapy/methods* ; Treatment Outcome ; Combined Modality Therapy

Pelvic floor biofeedback is a major non-surgical treatment for anorectal dysfunction and has been recommended in several foreign guidelines. There is no consensus on the clinical practice of pelvic floor biofeedback in China currently. There are controversies in indications, contraindications and formulation of protocols. Launched by Pelvic Floor Medicine Specialty Committee of World Federation of Chinese Medicine Societies and Anorectal Branch of Chinese Medical Doctor Association, Chinese experts on this field were convened to write the Chinese expert consensus on pelvic floor biofeedback for anorectal dysfunction based on relevant references and combined the latest evidence and experts' clinical experience. This consensus recommends that before the use of pelvic floor biofeedback therapy, the patient's condition and pelvic floor function should be fully evaluated, and the guiding role of doctors and pelvic floor therapists should be emphasized to guide the standardized use of pelvic floor biofeedback therapy.
Humans ; Pelvic Floor/physiopathology* ; Biofeedback, Psychology/methods* ; China ; Consensus ; Fecal Incontinence/therapy* ; Pelvic Floor Disorders/therapy*

OBJECTIVES: To study the clinical efficacy, advantages, and disadvantages of adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder in the treatment of children with outlet obstruction constipation (OOC). METHODS: A total of 168 children with OOC were enrolled in this prospective study. All the subjects were randomly divided into a test group and a control group based on the order of visiting time, 84 in each group. The test group was treated with adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder, and the control group was treated with oral administration of compound polyethylene glycol 4000-electrolyte powder alone. Eleven children in the test group and two children in the control group withdrew from the study since they could not finish the whole treatment course. Finally, 73 children in the test group and 82 children in the control group were included in this analysis. As clinical outcomes, the total score of clinical symptoms and overall response rate were compared between the two groups at weeks 4 and 8 of treatment. RESULTS: There was no significant difference in the total score of clinical symptoms between the two groups at beginning of treatment and at week 4 (P>0.05), while the test group had a significantly lower total score of clinical symptoms than the control group at week 8 (P<0.05). At week 4, there was no significant difference in overall response rate between the two groups (P>0.05), while the test group had a significantly higher overall response rate than the control group at week 8 (P<0.05). CONCLUSIONS Adaptive biofeedback training combined with oral administration of compound polyethylene glycol 4000-electrolyte powder is significantly associated with improvement of clinical outcomes in the treatment of children with OOC.
Administration, Oral ; Biofeedback, Psychology ; Child ; Constipation/drug therapy* ; Electrolytes/therapeutic use* ; Humans ; Polyethylene Glycols/therapeutic use* ; Powders/therapeutic use* ; Prospective Studies ; Treatment Outcome

OBJECTIVE: To study the clinical effect of psychological and behavioral intervention combined with biofeedback in the treatment of preschool children with attention deficit hyperactivity disorder (ADHD). METHODS: Sixty children each with inattentive, hyperactive/impulsive or combined type ADHD were enrolled. According to the intervention measure, they were randomly divided into 4 groups: control, psychological and behavioral intervention, biofeedback treatment and comprehensive treatment (psychological and behavioral intervention + biofeedback). Attention concentration time and impulse/hyperactivity and hyperactivity index scores of the Conners Parent Symptom Questionnaire (PSQ) were evaluated after 4 months of treatment. RESULTS: The attention concentration time increased in all types children with ADHD after psychological and behavioral intervention, biofeedback treatment or comprehensive treatment (P<0.05). In children with inattentive ADHD, hyperactive/impulsive ADHD or combined-type ADHD, biofeedback or comprehensive treatment reduced the impulse/hyperactivity index score (P<0.05). In children with inattentive or combined-type ADHD, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P<0.05). In children with hyperactive/impulsive ADHD, biofeedback treatment, psychological and behavioral intervention or comprehensive treatment reduced the hyperactivity index score (P<0.05). CONCLUSIONS In children with ADHD, psychological and behavioral intervention combined with biofeedback treatment can improve the attention concentration and impulsive/hyperactive and hyperactive symptoms. The treatment strategies are slightly different for children with different types of ADHD.
Attention Deficit Disorder with Hyperactivity ; Biofeedback, Psychology ; Child, Preschool ; Humans ; Parents ; Surveys and Questionnaires

Constipation is a common functional problem of the digestive system and may occur secondary to diet, drugs, endocrine diseases, metabolic diseases, neurological diseases, psychiatric disorders, or gastrointestinal obstruction. When there is no secondary cause, constipation is diagnosed as functional constipation. The first steps that should be taken to relieve symptoms are diet and lifestyle modifications, and if unsuccessful, laxative therapy should be initiated. If a patient does not respond to laxative therapy, diagnostic anorectal physiological tests are performed, though they are not routinely recommended. However, these tests may be considered earlier in patients strongly suspected to have a defecatory disorder. The revised guideline on the diagnosis and treatment of chronic constipation will undoubtedly aid the individualized management of chronic constipation in clinical practice.
Biofeedback, Psychology ; Constipation ; Diagnosis ; Diet ; Digestive System ; Digital Rectal Examination ; Endocrine System Diseases ; Humans ; Laxatives ; Life Style ; Metabolic Diseases

PURPOSE: There is no established treatment of choice for low anterior resection syndrome (LARS). To evaluate the efficacy of biofeedback therapy for objective improvement of pelvic function in LARS, we performed the present study. METHODS: The primary endpoint was the change of Wexner score. Consenting patients between 20 and 80 years old with major LARS at least 2 months after sphincter preserving proctectomy for rectal cancer were enrolled. After recommendation of biofeedback therapy, patients who accept it were enrolled in the biofeedback group and patients who refuse were enrolled in the control group. Initial and follow-up evaluations were performed and analyzed. RESULTS: Fifteen and sixteen patients were evaluated in the control group and the biofeedback group, respectively. There was no statistically significant difference of LARS score between both groups. Decrease in Wexner score and increase in rectal capacity were significantly higher in the biofeedback group (odds ratio [OR], 5.386; 95% confidence interval [CI], 1.194–24.287; P = 0.028 and OR, 1.061; 95% CI, 1.002–1.123; P = 0.042). CONCLUSION: Biofeedback therapy was superior for objective improvement of pelvic function to observation in LARS. It can be considered to induce more rapid improvement of major LARS.
Biofeedback, Psychology ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Manometry ; Postoperative Complications ; Rectal Neoplasms ; Rehabilitation

OBJECTIVE: Autonomic imbalance is considered a psychopathological mechanism underlying major depressive disorder (MDD). Heart rate variability (HRV) is an index for autonomic activation. Poor sleep quality is common among patients with MDD. HRV biofeedback (BF) has been used for regulating autonomic balance among patients with physical illness and mental disorders. The purpose of present study was to examine the effects of HRV-BF on depressive symptoms, sleep quality, pre-sleep arousal, and HRV indices, in patients with MDD and insomnia. METHODS: In this case-controlled study, patients with MDD and Pittsburgh Sleep Quality Index (PSQI) score higher than 6 were recruited. The HRV-BF group received weekly 60-minute protocol for 6 weeks, and the control group who have matched the age and sex received medical care only. All participants were assessed on Beck Depression Inventory-II, Back Anxiety Inventory, PSQI, and Pre-Sleep Arousal Scale. Breathing rates and electrocardiography were also performed under resting state at pre-testing, and post-testing conditions and for the HRV-BF group, also at 1-month follow-up. RESULTS: In the HRV-BF group, symptoms of depression and anxiety, sleep quality, and pre-sleep arousal were significantly improved, and increased HRV indices, compared with the control group. Moreover, in the HRV-BF group, significantly improved symptoms of depression and anxiety, decreased breathing rates, and increased HRV indices were detected at post-testing and at 1-month follow-up, compared with pre-testing values. CONCLUSION: This study confirmed that HRV-BF is a useful psychosocial intervention for improving autonomic balance, baroreflex, and symptoms of depression and insomnia in MDD patients.
Anxiety ; Arousal ; Baroreflex ; Biofeedback, Psychology ; Case-Control Studies ; Depression ; Depressive Disorder, Major ; Electrocardiography ; Follow-Up Studies ; Heart Rate ; Heart ; Humans ; Mental Disorders ; Respiration ; Sleep Initiation and Maintenance Disorders

PURPOSE: This study examined the effects of horse riding simulator exercise on the thickness changes in the transverse abdominis in normal adults. METHODS: Forty-five healthy adults were recruited and randomized to a horseback riding simulation exercise group (n=15), a sling exercise group (n=15), and a trunk stabilization exercise group (n=15). A horseback riding simulator offers the indoor experience of horseback riding and mimics the rhythmic movement of horseback riding, thereby provided a virtual environment, such as riding a real horse on the front screen. The velocity of the horse riding simulator exercise was regulated within the subject's ability to control the exercise on the horse riding simulator. A sling exercise group performed sling exercise under the inspection of the experimenter. In the trunk stabilization exercise group, the subjects were instructed to perform the exercise accurately and pause the session when pain occurred during the intervention. The subjects in each group carried out the interventions three times per week for six weeks. The thickness of the transverse abdominis was measured using a pressure biofeedback unit and the ultrasound. RESULTS: Significant differences in the thickness of transverse abdominis within the groups were observed between before and after the interventions. On the other hand, there were no differences in the parameters among the groups. CONCLUSION: Horse riding simulator exercise can be an alternative to trunk stabilization exercise by increasing the thickness of the transverse abdominis in healthy adults.
Adult ; Biofeedback, Psychology ; Hand ; Horses ; Humans ; Ultrasonography

To investigate the efficacy of manipulation combined with electrical stimulation and biofeedback on the treatment of female sexual dysfunction. 
 Methods: Seventy-two female patients with sexual dysfunction were recruited from the Third Xiangya Hospital of Central South University from January 2014 to December 2015. Subjects were randomly divided into three groups (A, B, and C). Patients in group A and group B received manipulation therapy and electrical stimulation biofeedback therapy, respectively, while patients in group C received manipulation combined with biofeedback electrical stimulation treatment for 30 days. The strength and fatigue degree of the type I and the type II muscle fiber of the pelvic muscles in all groups were evaluated before and one month after the treatment for further comparison. Questionnaire survey was used to investigate the frequency of sexual life and orgasm before and after treatment.
 Results: The strength and fatigue degree of patients in group C was significantly better than those of the other two groups (P<0.05).
 Conclusion: Manipulation therapy combined with electrical stimulation and biofeedback can effectively enhance the recovery of sexual dysfunction in postpartum women and improve the quality of sexual life for patients with postpartum sexual dysfunction. It therefore can be spread in clinical practice.
Biofeedback, Psychology ; Electric Stimulation ; Female ; Humans ; Physical Therapy Modalities ; Quality of Life ; Random Allocation ; Sexual Dysfunction, Physiological ; therapy ; Surveys and Questionnaires