Article: What to Look For in Biofeedback Treatment

* What specialized training did you receive to do this work?

Each profession (biofeedback, nursing, physical therapy) has several 2 to 5 days seminars every year on learning how to do pelvic muscle rehabilitation with biofeedback; at least one such Workshop would be minimal. Hearing a paper or presentation at the annual convention would not usually be considered enough training.

* Are you Certified in Biofeedback by the "Biofeedback Certification Institute of America (BCIA)"?

This will be hard to find, but represents a very high standard of preparation - in general biofeedback. If not they, are they supervised by someone who is certified?

* Are you a member of a ISSVD (physicians) or Women's Health section (physical therapists)?

The ISSVD, the International Society for the Study of Vulvovaginal Disease, and The Women's Health Section of the American Physical Therapy Association are both excellent sources of professional support and continuing education.

* What is the typical outcome for your patients using EMG biofeedback for vulvodynia?

It depends on the overall health of the typical patient in this clinic. In out-patient clinics where most patients are in otherwise good to excellent health, it should be a cure rate in the 50 percent range, and overall symptom reduction rate in the 85% range.

* What is the expected outcome in my case?

You will have to allow for your own physical condition in deciding what you consider a worthy answer here. Patient symptoms are extremely variable and satisfactory outcomes will be different for different patients.

* How long do you estimate the treatment will take?

In general, 9 months of diligent daily practice should get most otherwise healthy patients positive results. If your therapist doesn't have this skill, you might want to shop around. (By the way, it is considered good practice to over-train your muscles [beyond merely a single pain free week or even month] to prevent relapses.)

* How often will I get to use an EMG biofeedback instrument in my training?

There are two popular protocols, both based on the difficulty sometimes experienced in getting insurance coverage for take-home trainers. If a physician is doing the billing, the rental of a "home trainer" for daily biofeedback practice is sometimes absorbed into the weekly office visit charge. Physical Therapists can't do that, but they can let you practice in the PT clinic every day or every other day, and bill separately for "exercise". All of Dr. Arnold Kegel's patients had a home biofeedback device to practice with three times daily. The only published study of The Role of Home Trainers in Kegel Exercise Training is available for reading on Incontinet.com.

* Do you have vulvodynia treatment software running on a specialized biofeedback computer?

The use of general-purpose "relaxation"-type biofeedback software is not acceptable. There are several major companies that have developed software specific to evaluating and exercising the rather unique "pelvic muscles"; these programs also produce printed reports of your muscle condition to document your progress to the insurance company. If you want LESS than the best treatment available, well, it's your body!

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