Objective: To prove the benefits of pelvic floor muscle training with biofeedback (BFB) as a complementary treatment in women with bladder pain syndrome/interstitial cystitis (BPS/IC). Methods: Prospective, randomized study in 123 women with BPS/IC. Groups: BFB+ (n = 48): women with oral drug treatment (perphenazine and amitriptyline) plus intravesical instillations (sodium hyaluronate) plus pelvic floor muscle training with BFB; BFB−: (n = 75): women with oral drug treatment plus intravesical instillations. Variables: age, body mass index (BMI), time of follow-up, length of disease, time free of disease, diseases and health conditions concomitant, and responses to the SF-36 health-related quality of life questionnaire at the first consultation (SF-36 pre-treatment), and at the end of the study (SF-36 post-treatment). The treatment was considered successful when the SF-36 score reached values equal to or greater than 80 points or when the initial value increased by 30 or more points. Results: Mean age was 51.62 years old (23–82). BMI was higher in BFB−. The mean length of BPS/IC condition was 4.92 years (1–20), shorter in BFB+ than in BFB−. Mean SF-36 score pre-treatment was 45.92 points (40–58), lower in BFB+ than in BFB−. Post-treatment SF-36 score was higher than pre-treatment SF-36 score both in BFB+ and BFB−. SF-36 values were higher in BFB+ compared to BFB− over the follow-up. Conclusions: BFB improves quality of life in women with BPS/IC as adjunct therapy to combined oral and intravesical treatment.

Objectives: to demonstrate the benefits of physiotherapy (PT) with pelvic floor biofeedback (BFB) in improving health-related quality of life when used as a complementary therapy after surgical treatment of cystocele, in cases in which perineal pain or discomfort persists. Materials and methods: prospective observational study in 226 women who received complementary therapy after surgical treatment of cystocele due to persistent perineal discomfort or pain. Groups: GA (n = 78): women treated with 25 mg of oral pregabalin every 12 h plus BFB, consisting of 20 once-weekly therapy sessions, each 20 min long, with perineal pregelled surface electrodes connected to a screen which provides visual feedback; GB (n = 148): women treated with oral pregabalin 25 mg every 12 h without BFB. Variables: age, body mass index (BMI), time since onset of cystocele prior to surgery (TO), SF-36 health-related quality of life survey score, diseases and concomitant health conditions, follow-up time, success, or failure of postsurgical treatment. Results: average age 67.88 years (SD 12.33, 30–88), with no difference between GA and GB. Average body mass index (BMI) 27.08 (SD 0.45, 18.74–46.22), with no difference between GA and GB. Time since onset of cystocele prior to surgery (TO) was 6.61 years (SD 0.6), with no difference between GA and GB. Pretreatment SF-36 score was lower in GA success than GB success. Treatment was successful in 141 (63.20%) women and failed in 82 (36.80%). PT and age were the main predictors of success, and the least important were pretreatment SF-36 and the time elapsed after the intervention. In GA, 63 women (80.80%) showed improvement while 15 (19.20%) did not. Age was the main predictor of treatment success, while the least important was BMI. In GB, 78 women (53.80%) showed improvement while 67 (46.20%) did not improve. The main predictor was time since cystocele onset prior to surgery, while the least important was age. The odds ratio (OR) of improving quality of life for each unit increase in SF-36 was 11.5% (OR = 0.115) in all patients, with no difference between success and failure; in GA it was 23.80% (OR = 0.238), with a difference between success and failure; in GB it was 11.11% (OR = 0.111), with no difference between success and failure. GA and GB success had more history of eutocic delivery. GA success had more rUTI. GB success and GA failure both had more history of UI corrective surgery. The “failure” outcome had a higher number of patients with more than two concomitant pathological conditions. Conclusions: BFB as an adjunctive treatment improves quality of life in women suffering from persistent discomfort after surgery for cystocele. Young women who meet the criteria for recurrent urinary tract infection or who have a history of eutocic delivery show greater improvement. Body mass index does not influence response to treatment, while the presence of more than two concomitant conditions indicates a poor prognosis for improving quality of life.

Background: Acupuncture is one of the most popular forms of complementary and alternative medicine, and its usage is linked to an improvement of physical and psychological symptoms. Main Objectives: Determine whether the use of acupuncture as an adjunct to physiotherapy treatment is more effective than physiotherapy alone or acupuncture alone in MSK conditions. Methodology: A systematic review of the literature was conducted using three major databases, from March 2019 to May 2019, i.e., Cochrane Library, PubMed, and PEDro (Physiotherapy Evidence Database). The inclusion criteria were limited to randomized controlled trials (RCT) published in English, only studies published within the past decade, and investigating adult populations with MSK conditions. Results: From the 227 titles and abstracts that were identified, 75 were duplicates, leaving us with 152 studies for the initial screening. Eight studies [13-20] were included in this review for a qualitative analysis. The studies that assessed pain did not found statistically significant results that support the combination of physiotherapy and acupuncture, the same results were also obtained for Range of motion in knee osteoarthritis. Muscular tension was found statistically significant within-group improvements for all parameters in comparison with the baseline. For Isometric Neck Muscle Strength (INMS), the studies reported significant improvements within the groups, with Physiotherapy combined with Acupuncture being more effective than Acupuncture or Physiotherapy alone. The Constant Shoulder Assessment (CSA), for shoulder function was significantly higher in the exercise plus acupuncture group compared with the exercise group. Conclusion: As an integrative or complementary therapy for pain, acupuncture has been increasingly used. However, this review did not find significant evidence to support that the addition of acupuncture to physiotherapy treatment has an added benefit to pain relief. This review did, however, find benefits of adding acupuncture to treatment to reducing neck disability and improving muscular strength and shoulder function.