***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: CONTEXT Pelvic floor electrical stimulation ( PFES ) has been shown to be effective for stress incontinence . However , its role in a multicomponent behavioral training program has not been defined . OBJECTIVE To determine if PFES increases efficacy of behavioral training for community-dwelling women with stress incontinence . DESIGN AND SETTING Prospect i ve r and omized controlled trial conducted from October 1 , 1995 , through May 1 , 2001 , at a university-based outpatient continence clinic in the United States . PATIENTS Volunteer sample of 200 ambulatory , nondemented , community-dwelling women aged 40 to 78 years with stress or mixed incontinence with stress as the predominant pattern ; stratified by race , type of incontinence ( stress only vs mixed ) , and severity ( frequency of episodes ) . INTERVENTIONS Patients were r and omly assigned to 8 weeks ( 4 visits ) of behavioral training , 8 weeks ( 4 visits ) of the behavioral training plus home PFES , or 8 weeks of self-administered behavioral treatment using a self-help booklet ( control condition ) . MAIN OUTCOME MEASURES Primary outcome was percentage reduction in the number of incontinent episodes as documented in bladder diaries . Secondary outcomes were patient satisfaction and changes in quality of life . RESULTS Intention-to-treat analysis showed that incontinence was reduced a mean of 68.6 % with behavioral training , 71.9 % with behavioral training plus PFES , and 52.5 % with the self-help booklet ( P = .005 ) . In comparison with the self-help booklet , behavioral training ( P = .02 ) and behavioral training plus PFES ( P = .002 ) were significantly more effective , but they were not significantly different from each other ( P = .60 ) . The PFES group had significantly better patient self-perception of outcome ( P<.001 ) and satisfaction with progress ( P = .02 ) . Significant improvements were seen across all 3 groups on the Incontinence Impact Question naire but with no between-group differences . CONCLUSIONS Treatment with PFES did not increase effectiveness of a comprehensive behavioral program for women with stress incontinence . A self-help booklet reduced incontinence and improved quality of life but not as much as the clinic-based programs Biofeedback is a method of pelvic floor rehabilitation using a surface electrode inserted into the vagina and a catheter in the rectum . Forty women with genuine urinary stress incontinence were r and omized to compare the efficacy of physiotherapy and physiotherapy in combination with biofeedback . The effect of the treatment was determined by a st and ardized pad-weighing test . Long-term status was determined using a question naire after 2–3 years . Thirty-four women completed the treatment . The study showed a statistically significant better improvement in the biofeedback group . The long-term effect in the biofeedback group seemed better and the patients were more motivated for training afterwards This study was a r and omized controlled trial to investigate the effect of treating women with stress or mixed urinary incontinence ( SUI or MUI ) by diaphragmatic , deep abdominal and pelvic floor muscle ( PFM ) retraining .  Seventy women were r and omly allocated to the training ( n = 35 ) or control group ( n = 35 ) . Women in the training group received 8 individual clinical visits and followed a specific exercise program . Women in the control group performed self-monitored PFM exercises at home . The primary outcome measure was self-reported improvement . Secondary outcome measures were 20-min pad test , 3-day voiding diary , maximal vaginal squeeze pressure , holding time and quality of life . After a 4-month intervention period , more participants in the training group reported that they were cured or improved ( p < 0.01 ) . The cure/improved rate was above 90 % . Both amount of leakage and number of leaks were significantly lower in the training group ( p < 0.05 ) but not in the control group . More aspects of quality of life improved significantly in the training group than in the control group . Maximal vaginal squeeze pressure , however , decreased slightly in both groups . Coordinated retraining diaphragmatic , deep abdominal and PFM function could improve symptoms and quality of life . It may be an alternative management for women with SUI or MUI CONTEXT Previous research on urge urinary incontinence has demonstrated that multicomponent behavioral training with biofeedback is safe and effective , yet it has not been established whether biofeedback is an essential component that heightens therapeutic efficacy . OBJECTIVE To examine the role of biofeedback in a multicomponent behavioral training program for urge incontinence in community-dwelling older women . DESIGN Prospect i ve , r and omized controlled trial conducted from April 1 , 1995 , to March 30 , 2001 . SETTING University-based outpatient continence clinic in the United States . PATIENTS A volunteer sample of 222 ambulatory , nondemented , community-dwelling women aged 55 to 92 years with urge incontinence or mixed incontinence with urge as the predominant pattern . Patients were stratified by race , type of incontinence ( urge only vs mixed ) , and severity ( frequency of accidents ) . INTERVENTIONS Patients were r and omly assigned to receive 8 weeks ( 4 visits ) of biofeedback-assisted behavioral training ( n = 73 ) , 8 weeks ( 4 visits ) of behavioral training without biofeedback ( verbal feedback based on vaginal palpation ; n = 74 ) , or 8 weeks of self-administered behavioral treatment using a self-help booklet ( control condition ; n = 75 ) . MAIN OUTCOME MEASURES Reduction in the number of incontinence episodes as documented in bladder diaries , patients ' perceptions and satisfaction , and changes in quality of life . RESULTS Intention-to-treat analysis showed that behavioral training with biofeedback yielded a mean 63.1 % reduction ( SD , 42.7 % ) in incontinence , verbal feedback a mean 69.4 % reduction ( SD , 32.7 % ) , and the self-help booklet a mean 58.6 % reduction ( SD , 38.8 % ) . The 3 groups were not significantly different from each other ( P = .23 ) . The groups differed significantly regarding patient satisfaction : 75.0 % of the biofeedback group , 85.5 % of the verbal feedback group , and 55.7 % of the self-help booklet group reported being completely satisfied with treatment ( P = .001 ) . Significant improvements were seen across all 3 groups on 3 quality -of-life instruments , with no significant between-group differences . CONCLUSIONS Biofeedback to teach pelvic floor muscle control , verbal feedback based on vaginal palpation , and a self-help booklet in a first-line behavioral training program all achieved comparable improvements in urge incontinence in community-dwelling older women . Patients ' perceptions of treatment were significantly better for the 2 behavioral training interventions OBJECTIVE To compare the effect of individual pelvic floor muscle training with and without biofeedback in women with urodynamic stress incontinence METHODS The study was a single , blind , r and omized trial . All women completed 6 months of pelvic floor muscle training comprising three sets of ten contractions three times per day , supervised by a physical therapist . One group trained with a biofeedback apparatus at home , the other without biofeedback . The primary outcome measures were pad test with st and ardized bladder volume and self‐report of severity . RESULTS A total of 103 women were r and omized , and data from 94 women were analyzed . Mean age ( range ) was 46.6 ( 30–70 ) years , and mean ( range ) duration of symptoms was 9.7 ( 1–25 ) years . Seventy women had urodynamic stress incontinence alone , and 24 women reported additional urge symptoms . Women training with and without biofeedback showed a statistically significant reduction in leakage on pad test ( P < .01 ) after 6 months of pelvic floor muscle training . Objective cure ( 2 g or less of leakage ) in the total group was 58 % in women training with and 46 % in women training without biofeedback , and in the subgroup of women with urodynamic stress incontinence alone , 69 % in women training with and 50 % in women training without biofeedback . There was no statistically significant difference between the groups posttreatment in any outcome measure . CONCLUSION Cure rate was high , and the reduction in urinary leakage after treatment was statistically significant in both groups . However , there was no statistically significant difference in the effect of individual pelvic floor muscle training with and without biofeedback Pages I-H , Jahr S , Schaufele MK , Conradi E : Comparative analysis of biofeedback and physical therapy for treatment of urinary stress incontinence in women . Am J Phys Med Rehabil 2001;80:494–502 . Objective To compare the effectiveness of an intensive group physical therapy program with individual biofeedback training for female patients with urinary stress incontinence . Design R and omized study of two therapeutic interventions consisting of a specific physical therapy program ( PT ) or biofeedback training ( BF ) daily for 4 wk , followed by a 2-mo , unsupervised home exercise program in both groups in an outpatient clinic of a large university hospital . Forty women , referred by gynecologists for nonoperative treatment of genuine stress incontinence of mild-to-moderate severity , were included . Measurements of daytime/nocturnal urinary frequency and subjective improvement of incontinence were the main outcome measures at initial presentation , after completion of the therapy program , and at follow-up after 3 mo . St and ardized examinations of digital contraction strength , speculum tests , and manometric measurements were documented as secondary outcome measures . Results In the PT group , the daytime urination frequency decreased 22 % after 4 wk of therapy and 19 % after 3 mo ( P < 0.05 ) from baseline . The nocturnal urination frequency was reduced by 66 % after 4 wk of therapy and 62 % after 3 mo ( P < 0.001 ) . In the BF group , the daily urination frequency decreased 10 % after 4 wk of therapy and 5 % after 3 mo ( P > 0.05 ) . The nocturnal urination frequency declined 36 % after 4 wk of therapy and 66 % after 3 months ( P < 0.05 ) . Subjective assessment after 3 mo showed that in the PT group , 28 % of patients were free of incontinence episodes , 68 % reported improved symptoms ( incontinence episodes improved by > 50 % ) , and 4 % were unchanged . In the BF group , 62 % were free of incontinence episodes , and 38 % were improved . Results of the digital contraction strength assessment s , speculum tests , and manometric measurements showed statistically significant improvement in all variables in both groups after 3 months . Conclusion Four weeks of both intensive group physical therapy or individual biofeedback training followed by an unsupervised home exercise program for 2 mo are effective therapies for female urinary stress incontinence and result in a significantly reduced nocturnal urinary frequency and improved subjective outcome . Only group physical therapy result ed in reduced daytime urinary frequency . BF therapy result ed in a better subjective outcome and higher contraction pressures of the pelvic floor muscles OBJECTIVE To identify predictors of outcome of a multi-component behavioral training program for urge and stress incontinence in women . METHODS This report is a secondary analysis of data from three prospect i ve , r and omized , clinical trials testing behavioral interventions for urinary incontinence . Participants were a volunteer sample of 258 ambulatory , nondemented , community-dwelling women , aged 40–92 years , with stress , urge , or mixed urinary incontinence . Participants received 8 weeks ( four visits ) of multicomponent behavioral training in each study . The relationship between a number of variables and treatment success were explored by univariate and multivariable logistic regression analyses . RESULTS Successful treatment of predominantly urge incontinence ( 75 % reduction of incontinent episodes as recorded on bladder diary ) was associated with not wearing any form of protection for incontinence ( P = .045 ; 95 % confidence interval [ CI ] .282 , .987 ) . Achieving total continence ( 100 % reduction ) was associated with fewer incontinent episodes at baseline ( P < .001 ; 95 % CI .138 , .557 ) , previous surgery for incontinence ( P = .021 ; 95 % CI 1.169 , 6.543 ) , and lower education level ( P = .022 ; 95 % CI .175 , .871 ) . Successful treatment of predominantly stress incontinence ( 75 % reduction ) was related to not having previous evaluation or treatment for incontinence ( P = .001 ; 95 % CI .026 , .415 ) , and fewer incontinent episodes on baseline bladder diary ( P = .026 ; 95 % CI .210 , .907 ) . Outcomes were not associated with age , race , type of incontinence , or a number of other variables reflecting medical history , obstetric history , medications , pelvic examination , body mass index , urodynamic parameters , or psychological distress . CONCLUSION Aside from indicators of severity and previous treatment , there were few associations between baseline clinical variables and outcome of behavioral treatment UNLABELLED We performed a r and omized clinical trial on the efficacy of physical therapy on genuine stress incontinence .  STUDY OBJECTIVE 
    Output:
    
However , it was common for women in the biofeedback arms to have more contact with the health professional than those in the non-biofeedback arms .
There was much variety in the regimens proposed for adding feedback or biofeedback to PFMT alone , and it was often not clear what the actual intervention comprised or what the purpose of the intervention was .
Feedback or biofeedback may provide benefit in addition to pelvic floor muscle training in women with urinary incontinence .