Biofeedback pelvic floor exercise therapy for pelvic floor dyssynergia: an observational study
Keywords:Anal manomentry, Behavioural therapy, Constipation, PFD, Quality of life, Resting pressure
Background: Pelvic floor dyssynergia (PFD) is one of the commonest subtypes of constipation and treated conservatively but is often unsatisfactory. Biofeedback Pelvic Floor Exercise Therapy (BFT) has been introduced as an alternative treatment.
Method: A prospective study was conducted at Healing Hands Clinic, Pune. Total 35 patients diagnosed as having pelvic floor dyssynergia confirmed by MR defecography (MRD) enrolled in to the study. All patients trained for pelvic floor muscle exercise. Patient performed exercise 20 minutes per day for 12 weeks. Data have been collected using a standardized questionnaire (Longo's obstructed defecation syndrome (ODS) score, Patient Assessment of Constipation Quality of Life (PAC-QOL) and Bristol stool score and performed anal manomentry test (3-D HDAM) at every 4 weeks.
Result: Study result demonstrated a statistically significant improvement in the mean resting pressure, maximum squeezing pressure and average of 10 seconds hold (from 69.83±6.40 to 39.87±5.51, 98.67±17.23 to 128.67±26.92, 78.70±15.41 to 109.00±22.23, P = 0.005 at week 12). The mean total ODS decreased significantly (p<0.0005) from baseline to 22.92±4.03 to 11.46±6.76 at week 12. Also, individuals ODS score items were significantly improved at week 8 and week 12. Bristol stool score significantly improved from 2.12±1.14 to 4.04±0.96 at 12 weeks (p<0.0005). Significant improvements were recorded in all four individual score domains (physical discomfort, psychosocial discomfort, worries and concerns, satisfaction) and total score of PAC-QOL at week 12.
Conclusion: Biofeedback therapy provides improvement in bowel symptoms, anorectal function and reduces use of aperients in constipated subjects with pelvic floor dyssynergia
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