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Bei der vorliegenden Studie handelt es sich um eine multizentrische Vergleichsstudie menopausaler Beschwerden an Patientinnen in Deutschland und China.

Bei der vorliegenden Studie handelt es sich um eine kontrollierte Beobachtungsstudie ohne Randomisierung mit 64 an rheumatoider Arthritis der Hände und/oder Füße leidenden Patienten.

Da ältere Menschen häufig von Stuhlinkontinenz betroffen, aber oftmals nicht mobil genug sind, an einem ambulanten, anorektalen Biofeedbacktraining in einer Spezialambulanz teilzunehmen, sollte die Effektivität eines Heimtrainingsprogramms bei älteren Menschen, die sowohl die kognitiven wie auch körperlichenVoraussetzungen für ein solches Trainingsprogramm erfüllen, untersucht werden. Zwei Gruppen von Teilnehmerinnen im Alter von 49 bis 63 Jahren bzw. 65 bis 78 Jahren, die unter analer Inkontinenz litten, bekamen nach einer anorektalen Funktionsdiagnostik eine umfangreiche Schulung und Einweisung in ein Sphinktertrainingsprogramm mit einem Heimbiofeedbackgerät. Nach im Mittel etwa 9 Monaten Training erfolgte eine Nachuntersuchung. Für beide Gruppen zeigte sich eine deutliche Zunahme der Kontraktionskraft des externen Analsphinkters und damit der Willkürfunktion des anorektalen Verschlussapparates. Es zeigte sich keine Altersabhängigkeit des Therapieerfolgs, die Verbesserung der Kontinenzfunktion war für beide Gruppen gleich. Es wird der Schluss gezogen, dass ein gut betreutes Heimtrainingsprogramm für ältere, in ihrer Mobilität bereits eingeschränkte Menschen eine Alternative zum ambulanten Biofeedbacktraining sein kann. The increased prevalence of urinary and fecal incontinence is one of the most important factors in the loss of independence and mobility in the elderly population. It is also one of the major reasons for elderly people to give up their household and move into a nursing home. Anorectal biofeedback therapy is a very effective treatment for fecal incontinence. However, due to the increased immobility of elderly people, ambulatory biofeedback training programs which require the participants to leave their homes and travel to the next available outpatient clinic on a regular basis, especially when depending on public transportation, may prove particularly difficult for elderly, incontinent subjects. Supervised home biofeedback training programs may offer an alternative for those patients, who are motivated enough and not mentally impaired. Two different age groups of women (between 49 and 63; and between 65 and 78 years old) suffering from fecal incontinence due to external anal sphincter impairment, received a supervised home biofeedback program, after extensive anorectal diagnostics including manometry. The program focused on improving voluntary sphincter contraction. After an average of 9 months, anorectal manometry was repeated, and anal resting and squeeze pressure as well as minimal rectal perception threshold were determined. There was no effect on anal resting pressure and rectal perception. However, anal maximum squeeze pressure as well as squeeze pressure over 10 s was substantially increased with no difference between the age groups. Conclusion: Supervised home biofeedback for sphincter insufficiency was effective in improving the voluntary contraction of the anorectum in both age groups. Therefore, biofeedback home training programs may offer an alternative to ambulatory programs for those individuals, who are not mobile enough to regularly attend an outpatient clinic.

Biofeedback in Disordered Defecation (Fecal Incontinence / Obstipation)In gastroenterology, biofeedback training has been shown to be the treatment of choice for 2 groups of patients with disordered defecation: those suffering from fecal incontinence or spastic pelvic floor syndrome. Biofeedback is based on the fact that electrical impulses, generated by an active muscle, can be fed back in the form of audible and visible signals, so that the patients can be taught to recognize and consciously influence normally unconscious body functions such as anal sphincter contraction, rectal sensation or pelvic floor muscle function. In fecal incontinence as well as in spastic pelvic floor syndrome controlled studies have shown biofeedback training to be superior compared to conventional treatment modalities with success rates ranging between 50 and 80%, depending of the efficacy criteria applied. In both cases, a diagnostic strategy to select patients who would profit from this therapy is most important. An analysis of the published biofeedback studies for anorectal dysfunction shows that, although biofeedback is a useful tool in the treatment of these dysfunction, the mechanisms involved in its efficacy are unclear and standardization criteria are still to be found for diagnostic evaluation of patients as well as for outcome evaluation. This article describes the historical development of biofeedback training, the clinical protocols for treating patients with fecal incontinence or spastic pelvic floor syndrome, and gives a short summary of the published studies.