{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T15:10:19Z","timestamp":1781277019145,"version":"3.54.1"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2016,7,20]],"date-time":"2016-07-20T00:00:00Z","timestamp":1468972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Biofeedback therapy (<jats:styled-content style=\"fixed-case\">BFT<\/jats:styled-content>) is an established treatment for fecal incontinence (<jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content>), with access often being restricted to tertiary centers due to resources and the perceived requirement for high\u2010intensity regimes. However, the optimal regime remains unknown. We evaluated outcomes from our low\u2010intensity integrated <jats:styled-content style=\"fixed-case\">BFT<\/jats:styled-content> program in a secondary care center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Outcomes of our <jats:styled-content style=\"fixed-case\">BFT<\/jats:styled-content> service for <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> were evaluated retrospectively. Response was defined by \u226550% improvement in <jats:styled-content style=\"fixed-case\">FI<\/jats:styled-content> frequency from baseline or complete continence. Responders were compared to non\u2010responders for factors including symptoms, manometry data, sphincter exercise technique and duration of practice, and the number and frequency of sessions. Where patients dropped out, outcomes and the reason for dropout were obtained retrospectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Fecal incontinence patients (n=205, median 62\u00a0years, 72% female) attended a median (<jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>) 3 (2) <jats:styled-content style=\"fixed-case\">BFT<\/jats:styled-content> sessions with 55 (36) days between visits. Overall, 146\/205 (71%) responded with 97\/205 (47%) achieving continence. Fecal incontinence frequency improved dramatically in completed cases (<jats:italic>P<\/jats:italic>=0.000). While non\u2010response was associated with males (<jats:italic>P<\/jats:italic>=0.03) and dropout (<jats:italic>P<\/jats:italic>=0.000), \u201cgood\u201d anal sphincter exercise technique (<jats:italic>P<\/jats:italic>=0.008) and longer in\u2010home practice (<jats:italic>P<\/jats:italic>=0.007) and more sessions (<jats:italic>P<\/jats:italic>=0.04) were associated with response. Dropout rate was 80\/205 (39%), with the reason for dropout being obtained in 80%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions &amp; Inferences<\/jats:title><jats:p>Despite low\u2010intensity <jats:styled-content style=\"fixed-case\">BFT<\/jats:styled-content>, comparable outcomes to data from tertiary centers were achieved. Our data emphasize the importance of technique and in\u2010home practice of anal sphincter exercises. Customizing <jats:styled-content style=\"fixed-case\">BFT<\/jats:styled-content> intensity based on predictive factors and encouraging in\u2010home practice may optimize outcomes, reduce dropout rates, and rationalize resources.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.12912","type":"journal-article","created":{"date-parts":[[2016,7,21]],"date-time":"2016-07-21T02:06:50Z","timestamp":1469066810000},"source":"Crossref","is-referenced-by-count":9,"title":["Integrated low\u2010intensity biofeedback therapy in fecal incontinence: evidence that \u201cgood\u201d in\u2010home anal sphincter exercise practice makes perfect"],"prefix":"10.1111","volume":"29","author":[{"given":"D. H.","family":"Vasant","sequence":"first","affiliation":[{"name":"GI Physiology and Gastroenterology Departments Pennine Acute Hospitals NHS Trust  Greater Manchester UK"},{"name":"Manchester Academic Health Sciences Centre University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Solanki","sequence":"additional","affiliation":[{"name":"GI Physiology and Gastroenterology Departments Pennine Acute Hospitals NHS Trust  Greater Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Balakrishnan","sequence":"additional","affiliation":[{"name":"GI Physiology and Gastroenterology Departments Pennine Acute Hospitals NHS Trust  Greater Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. V.","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"GI Physiology and Gastroenterology Departments Pennine Acute Hospitals NHS Trust  Greater Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.04.006"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.AOG.0000266981.69332.db"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-0593-0"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.50.4.480"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.303"},{"key":"e_1_2_10_7_1","first-page":"2360","article-title":"Can biofeedback therapy improve anorectal function in fecal incontinence?","volume":"91","author":"Rao SS","year":"1996","journal-title":"Am J Gastroenterol"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02055441"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.22715"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/DCR.0b013e3181b55455"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1463-1318.2009.01881.x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02049311"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2004.02125.x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02054228"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12520"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39231.633275.AD"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2014.190"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2005.11.064"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2009.01345.x"},{"key":"e_1_2_10_20_1","first-page":"CD002111","article-title":"Biofeedback and\/or sphincter exercises for the treatment of faecal incontinence in adults","volume":"7","author":"Norton C","year":"2012","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12809"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gtc.2008.06.011"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1999.00950.x"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2168.1999.01215.x"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2013.837954"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6643-9"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05429.x"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02055440"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-004-6718-7"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02236932"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/MCG.0b013e318266f43a"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10350-006-0846-1"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(11)61499-6"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384-016-2585-7"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gastro.2003.09.039"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.40105.x"}],"container-title":["Neurogastroenterology &amp; 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