Biofeedback Therapy for Defecation Disorders

Rao, Satish S.C.; Enck, Paul; Loening‐Baucke, Vera

doi:10.1159/000171623

Cited by 77 publications

(54 citation statements)

References 38 publications

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“…For example, Hay-Smith suggested that the regimen should consist on 3 sets of 8 to 12 tonic contractions sustained for 8 to 10 seconds each, and performed 3 times a day; these must be continued for 15 to 20 weeks (20). Munoz -Bono reported that the treatment protocol for faecal incontinence might vary from 1 to 15 sessions, which is due to the difference in learning and comprehension between patients, as stated by Rao (21,22). Gilliland goes even further and states that BFB effectiveness seems to be related to the number of sessions (23).…”

Section: Discussionmentioning

confidence: 99%

“…The partnership between patient-physiotherapist: a) increases patient satisfaction and improves compliance and adherence to treatment, b) lets a rapid recognition of pelvic floor muscle exercises (13), and c) enhances learning and comprehension of exercises, since the number of sessions are dependent on patients motivation and cognitive level (21,22).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Manometric Biofeedback Effectiveness on Urinary Incontinence and Quality of Life: A Non-Randomized Control Trial

Fernández-Cuadros

Diez-Ramos

Albaladejo-Florín

et al. 2017

Middle East J Rehabil Health Stud

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Objectives: This study aimed at examining if a 6-session protocol of tonic-phasic exercises using manometric biofeedback (BFB) is capable of improving quality of life (QoL) and muscular strength in patients with urinary incontinence (UI). Methods: A prospective quasi-experimental before-after study was performed on 31 patients with Urinary Incontinence (UI) referred to the rehabilitation department of Santa Cristina's University hospital, Madrid, Spain. The study was performed from January to December 2016. At initial evaluation, affiliation of data, predisposing factors, and type of UI were recorded. Patients were given lifestyle recommendations and international consultation on incontinence questionnaire short form (ICIQ-SF)/ incontinence quality-of-life measure (I-QOL) questionnaires/scales to be fulfilled at the beginning/end of treatment. Manometric evaluation was recorded at initial/final evaluation by MYOMED ® 932. Manometric-BFB protocol consisted of a 30-minute session of tonic/phasic exercises (15 minutes each), 2 times a week for up to 6 sessions, supervised by a physiotherapist. Results:Mean age was 52 ± 12.1 years. Overall, 96.7% (n = 31) of the participants were females. Maximum and mean strength of pelvic floor contraction was 24 ± 17.72 and 4.9 ± 4.1 mmHg, and increased significantly after treatment to 35 ± 20.85 and 7.45 ± 4.92 mmHg (P < 0.01). The mean ICIQ-SF score was 9.13 ± 5.18 and decreased significantly to 6.13 ± 4.75 (P = 0.003). The mean I-QoL score increased significantly from 70.33 ± 22.12 to 81.25 ± 16.72 (P = 0.0017). The I-QoL Limiting Behaviour (LB)-subscale raised from 68.38 ± 23.33 to 80 ± 16.56 (P = 0.0015); I-QoL Psychosocial Impact (PI)-subscale increased from 77.43 ± 24.51 to 80 ± 17.47 (p = 0.0152); and I-QoL social embarrassment (SE)-subscale incremented from 60.72 ± 22.37 to 74.37 ± 20.86 (P = 0.0007). Conclusions:Manometric-BFB protocol is capable of decreasing UI and to improve QoL and manometric values. This reduced protocol could be applied to other public and private institutions and it could have an economical impact on the health system and on patients' economy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Manometric Biofeedback Effectiveness on Urinary Incontinence and Quality of Life: A Non-Randomized Control Trial

Fernández-Cuadros

Diez-Ramos

Albaladejo-Florín

et al. 2017

Middle East J Rehabil Health Stud

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“…Children with severe constipation were treated with rectal stimulant laxatives or enemas. Before and after each biofeedback training session, parents and the children received psychosocial intervention, including: (1) daily registration; (2) toilet training and anal sphincter exercises (squeeze and push to increase rectal sensitivity, and squeeze in endurance to improve muscle strength); (3) behavioral modification techniques; (4) positive approach; (5) demystification (explanation of relationship between constipation, fecal incontinence, and child behavior); (6) individual psychosocial analysis (using DSM classifications to characterize the child) [19]; (7) biofeedback training (biofeedback training is based on operant conditioning [9,15] and is described in detail elsewhere [2,9,14,19,20]). The number of training sessions varies from 3 to 9 consecutive weeks (average number of six sessions).…”

Section: Methodsmentioning

confidence: 99%

Psychosocial co-morbidity affects treatment outcome in children with fecal incontinence

Everdingen-Faasen

Gerritsen²,

Mulder

et al. 2007

Eur J Pediatr

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Fecal incontinence is a common disorder in children. Many children with fecal incontinence have psychosocial co-morbidity. In this study, the effect of psychosocial co-morbidity on the treatment outcome of children with fecal incontinence was evaluated. One hundred and fifty children with fecal incontinence were treated in a multidisciplinary program. All children had been treated unsuccessfully for at least one year before entering the program. The treatment consisted of laxative treatment, psychosocial interventions, and biofeedback training. Psychosocial co-morbidity was classified according to the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV). One hundred and forty-one children were completely analyzed (102 boys, mean age 9.6 (range 6.5-16.5) years). Of these, 31 (22%) children had fecal incontinence without constipation and 110 (78%) children had fecal incontinence associated with constipation. In 95% of children, at least one psychosocial co-morbidity was present. Treatment was successful at 12 months in 69% of patients. Treatment was less successful in children with attention deficit hyperactivity disorder (ADHD), in children with parent-child relational problems, and in mentally retarded children. The results indicate that the early assessment and treatment of psychosocial co-morbidity might improve treatment response in children with fecal incontinence. Children with fecal incontinence are treated less successfully in the first year if they have ADHD, parent-child relational problems, or mental retardation. Psychosocial evaluation and the early assessment and treatment of psychosocial co-morbidity is indicated in order to improve response rate. Family counseling--aimed at improving parent-child relations--should be an integral part of a multidisciplinary treatment program for fecal incontinence.

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“…Biofeedback has been used in the treatment of FI with variable results [17][18][19][20]. Electric stimulation or neuromodulation of the pelvic floor has also been used in the treatment of idiopathic FI.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Peripheral Neuromodulation in the Treatment of Fecal Incontinence

et al. 2003

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Background/Aims: To assess the results of peripheral neuromodulation for the treatment of fecal incontinence (FI) resulting from uninhibited rectal contraction (URC) or uninhibited anal sphincter relaxation (UASR). Methods: The work comprised 32 patients (age 38.2 ± 6.7 years; 22 women) with FI in whom conventional therapy had failed before enrollment in the study. Twenty-six had URC and 6 UASR. Peripheral neurostimulation was effected by posterior tibial nerve stimulation using a Stoller Afferent Nerve Stimulator (UroSurge, Coralville, lowa, USA). The needle was introduced into the skin cephalad to the medial malleolus. Stimulation (parameters: 0.5–10 mA, 200 µs, 20 Hz) was performed every other day for 4 weeks. Functional assessment was done by a questionnaire (incontinence score: 0–20) and physiologic studies. Results: Group 1: 17 patients (13 URC, 4 UASR) had FI improvement, recording a mean score of 1.7 of 20. Group 2: 10 patients (8 URC, 2 UASR) had fair improvement (score 8.6). Group 3: 5 patients had poor results (score 14.8). Rectometric recording showed improvement in groups 1 and 2. Recurrence of symptoms occurred in 8 patients; 6 improved after retreatment. Conclusions: A percutaneous access to the S₃ spinal region was achieved through the posterior tibial nerve. Improvement of FI was achieved in 78.2%. The technique is simple, easy, without complications and cost-effective. It can be done as an outpatient procedure or by the patient at home. The results need to be reproduced on a large number of patients.

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Biofeedback Therapy for Defecation Disorders

Cited by 77 publications

References 38 publications

Manometric Biofeedback Effectiveness on Urinary Incontinence and Quality of Life: A Non-Randomized Control Trial

Manometric Biofeedback Effectiveness on Urinary Incontinence and Quality of Life: A Non-Randomized Control Trial

Psychosocial co-morbidity affects treatment outcome in children with fecal incontinence

Percutaneous Peripheral Neuromodulation in the Treatment of Fecal Incontinence

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