The immediate effectiveness of mobile game-based instruction with an extracorporeal biofeedback device for an exercise program to improve pelvic floor muscle contraction in healthy subjects

Objective: Using biofeedback in instructing pelvic floor muscle (PFM) activation is a great method to provide information on muscle contraction. This study aimed to determine the immediate effectiveness of a mobile game-based instruction with an extracorporeal biofeedback device (EBD) to improve PFM contraction in healthy subjects. Design: Cross-sectional study. Methods: Sixteen healthy subjects (4 men and 12 nulliparous women; age, 31±5 years) were enrolled. The subjects were randomly categorized into two groups, those who were to receive instructions on how to contract the PFM by using the EBD (n=7) and those who were to undergo a transabdominal ultrasonography (TAUS; n=9) with biofeedback. PFM function was measured as the displacement (mm) of PFM elevation by using the TAUS before and after the instructions in each group. Results: The EBD and TAUS groups showed a significant increase in the displacement of PFM elevation after the instructions from 5.93±4.03 mm to 7.62±3.77 mm and from 5.27±3.39 mm to 7.47±2.79 mm, respectively (p<0.05). No significant differences were found between the two groups. Conclusions: The results of this study indicated that instructions for PFM contraction using the EBD and TAUS showed an immediate effect; however, no significant difference in effectiveness was observed between the two instruction methods. Therefore, not only can the TAUS method be used but the EBD method can also be used as a PFM instruction method for noninvasive procedures. However, further studies are needed to demonstrate the effectiveness of training and exercise on larger sample sizes that includes patient populations with PFM dysfunction.