A Global Scoping Review of Clinicians' Perceptions of Anorectal Biofeedback Compared with Novel Australian Data

Background/Objectives: Biofeedback therapy is a technique that trains individuals to change their physiological activity for the purpose of improving their health. Despite its proven efficacy in 70 to 80% of patients in clinical trials, biofeedback is significantly underutilised in clinical practice worldwide. This scoping review aims to synthesise the current evidence on clinicians' attitudes, knowledge, and experiences with anorectal biofeedback, highlight gaps in the existing literature, and guide future research directions. These findings are compared with new local Australian data. Methods: Systematic searches were conducted on five electronic databases including MEDLINE, Embase, CINAHL, Scopus, and APA PsycInfo. Eight articles were retrieved from title and abstract, full text, and reference list screening using Covidence. Results: The scoping review revealed substantial heterogeneity in the clinical indications for biofeedback. Both the scoping review and Australian study reported that over half of clinicians could not accurately define biofeedback or report familiarity with the technique, and that barriers to the implementation of biofeedback included long wait times, lack of trained personnel, and limited access to equipment. In the Australian study, proposed ways to improve the uptake of biofeedback included education of health professionals, government funding, and increased access to facilities. Conclusions: This scoping review and Australian cross-sectional study demonstrate that clinicians have limited knowledge of biofeedback and that a complex interplay between systemic barriers to access hinder its implementation. Further research into clinicians' attitudes towards biofeedback should be conducted in more countries to build a more robust body of evidence.