Development of an e-learning program for biofeedback in pelvic floor muscle training for adult women using self-performed ultrasound: An observational study.

Abstract

Pelvic floor muscle training (PFMT) for urinary incontinence (UI) is recommended in combination with biofeedback to visualize pelvic floor muscles. The focus is on non-invasive hand-held ultrasound (US) measurement methods for PFMT, which can be performed at home. Recently, self-performed US measurements in which the patient applies the US to themself have gradually spreading. This study aimed to develop an educational program for the biofeedback method using self-performed US and to evaluate its feasibility. This study was an observational study. The ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) was utilized to create an e-learning program for women aged ≥40 years with UI. Participants self-performed bladder US via e-learning, using a hand-held US device with a convex probe. The primary outcome was the number of times the bladder area was successfully extracted using an existing automatic bladder area extraction system. The secondary outcome was the total score of the technical evaluation of the self-performed US, which was evaluated across three proficiency levels. Descriptive statistics were conducted for participant characteristics, presenting categorical variables as percentages and continuous variables as means ± SD. We included 11 participants with a mean age of 56.2 years. Nine participants were able to record US videos, and two were unable to record bladder videos. Regarding the technical evaluation scores, all participants scored ≥80%; four had perfect scores. This study showed that transabdominal self-performed bladder US can be performed in 81.8% of women with UI in their 40-60s by using an e-learning program.