Objective:

To investigate the clinical effects of EMG-BF-supported PFMT vs. standard PFMT in women with SUI.

Approach:

• Methodology: Systematic review and meta-analysis following PRISMA 2020, including RCTs comparing EMG-BF-assisted PFMT vs. PFMT alone, with outcomes pooled as standardized mean differences (SMDs).

Key Findings:

• Eight RCTs (n = 1,045; EMG-BF + PFMT: 518; PFMT: 527) were included.
• EMG-BF-assisted PFMT showed a small reduction in incontinence severity (SMD = -0.17, 95% CI -0.30 to -0.05).
• Mild benefit in quality of life (SMD = -0.21, 95% CI -0.34 to -0.08).
• Moderate improvement in pelvic floor muscle strength (SMD = 0.56, 95% CI: 0.09–1.03).
• Potential small-study effects for incontinence severity (p = 0.0118).

Interpretation:

The addition of EMG-BF to PFMT provides small but statistically significant improvements in symptoms and quality of life compared to PFMT alone, with a greater benefit observed for pelvic floor muscle strength.

Limitations:

• Heterogeneity in study designs and populations.
• Potential publication bias indicated by Egger's test.

Conclusion:

EMG-BF may be beneficial for women who have difficulty recognizing correct pelvic floor contractions or require additional structure at the beginning of training.