Pelvic Floor Muscle Training: From Individuals’ Experience and Empowerment to the Development of a New Biofeedback Device

Background: Pelvic Floor Muscle Training (PFMT) is a key treatment for Urinary Incontinence (UI). This intervention presents various challenges, including taboos, the need for patients’ empowerment and self-management, and the use of invasive approaches. Quantitative and qualitative research are crucial to enhancing PFMT engagement and satisfaction. Methods: The five studies investigated: 1) users with UI experience with PFMT (qualitative study); 2) empowerment strategies of pelvic floor physiotherapists (qualitative study); 3) efficacy of internal devices in addition to PFMT for UI post-prostatectomy (systematic review with meta-analysis); 4) users with UI experience with invasive devices (qualitative study); 5) feasibility of a non-invasive device for PFMT and the synergistic roles of obliquus internus and multifidus muscles, in pelvic floor muscle contractions, in healthy men (proof-of-concept study design). Results: In Study 1, we found that proper PFMT improved users’ understanding of pelvic floor health and led to self-management. Study 2 revealed that empowerment requires a holistic, patient-centred approach, integrating communication, education, collaboration, and continuous support. Study 3 found uncertain evidence for internal devices as adjuncts to PFMT. Study 4 highlighted that invasive devices often cause anxiety and discomfort but are valued for enhancing pelvic floor muscle awareness. Study 5 reported that an external pressure device showed promising results in monitoring pelvic floor contraction in healthy men, with the co-activation of core muscles providing an additional opportunity for non-invasive biofeedback. Conclusions: PFMT enhances pelvic floor health, continence, and self-management by fostering body awareness and empowering users through active exercises and patient-centred physiotherapy. While invasive devices may cause discomfort, non-invasive alternatives, like an external pressure device and core muscle synergy, might be a future solution.