Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: A systematic review

Desantis, Darren; Leonard, Michael P.; Preston, Mark A.; Barrowman, Nicholas J.; Guerra, Luis

doi:10.1016/j.jpurol.2011.02.019

Cited by 64 publications

(30 citation statements)

References 27 publications

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“…Given that no studies have so far been published on the effect of PPT in childhood constipation [52] and that a repeat survey on standard PPT among 49 Dutch physiotherapists in 2011 did not yield substantial differences compared to the 2007 survey, we feel this protocol is as up-to-date as possible.…”

Section: Discussionmentioning

confidence: 99%

The effect of pelvic physiotherapy on reduction of functional constipation in children: design of a multicentre randomised controlled trial

et al. 2013

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BackgroundFunctional constipation is a common disorder worldwide and is found in all paediatric age groups. Functional constipation can be caused by delayed colonic transit or dysfunction of the pelvic floor muscles. Standard medical care in paediatric practice is often based on clinical experience and mainly consists of a behavioural approach and toilet training, along with the prescription of laxatives. Evidence to evaluate the effectiveness of pelvic physiotherapy for this complaint is lacking.Methods/designA two-armed multicentre randomised controlled trial has been designed. We hypothesise that the combination of pelvic physiotherapy and standard medical care will be more effective than standard medical care alone for constipated children, aged 5 to 17 years. Children with functional constipation according to the Rome III will be included. Web-based baseline and follow-up measurements, scheduled at 3 and 6 months after inclusion, consist of the numeric rating scale in relation to the perceived severity of the problem, the Strength and Difficulties Questionnaire and subjective improvement post-intervention (global perceived effect). Examination of the pelvic floor muscle functions, including digital testing and biofeedback, will take place during baseline and follow-up measurements at the physiotherapist. The control group will only receive standard medical care, involving at least three contacts during five months, whereas the experimental group will receive standard medical care plus pelvic physiotherapy, with a maximum of six contacts. The physiotherapy intervention will include standard medical care, pelvic floor muscle training, attention to breathing, relaxation and awareness of body and posture. The study duration will be six months from randomisation, with a three-year recruitment period. The primary outcome is the absence of functional constipation according to the Rome III criteria.DiscussionThis section discusses the relevance of publishing the study design and the development of the presented physiotherapy protocol. It also addresses difficulties when interpreting the literature with regard to the effectiveness of biofeedback, potential confounding, and future research indications. To our knowledge, this article is the first to describe the design of a randomised controlled trial among children with constipation to assess the effect of pelvic physiotherapy as an add-on to standard medical care.Trial registrationCurrent Controlled Trials NL30551.068.09

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Section: Discussionmentioning

confidence: 99%

The effect of pelvic physiotherapy on reduction of functional constipation in children: design of a multicentre randomised controlled trial

et al. 2013

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“…In those studies, patients were treated with biofeedback without stratification based on the mechanism responsible for the constipation (rectal pressure vs anal canal relaxation). Finally, more recent studies have now shown a long-term benefit to biofeedback in chronically constipated children (21)(22)(23). Additionally, some children received only 1 to 2 sessions of biofeedback (19).…”

Section: Discussionmentioning

confidence: 99%

Bear‐Down Maneuver Is a Useful Adjunct in the Evaluation of Children With Chronic Constipation

Belkind‐Gerson

Surjanhata²,

Kuo³

et al. 2013

J. pediatr. gastroenterol. nutr.

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“…Biofeedback training as the most specific and effective treatment can be performed at home. In a meta‐analysis, biofeedback showed an improvement in 80% of cases . In a recent study of 64 children with DV, 56 underwent extended urotherapy with a median duration of treatment of 18 weeks.…”

Section: Current Management Of DV In Childhoodmentioning

confidence: 99%

Can we improve our management of dysfunctional voiding in children and adults: International Consultation on Incontinence Research Society; ICI‐RS2018?

Tarcan

Gontard

Apostolidis

et al. 2019

Neurourology and Urodynamics

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Aims: Dysfunctional voiding (DV) remains a poorly understood and a poorly managed problem, both in children and adults. The Think Tank (TT) discussed how to improve the management of DV in these two different age groups and in transitional care. Methods: During the 2018 International Consultation on Incontinence Research Society held in Bristol, a multidisciplinary TT on DV was created. The presentations and subsequent discussion, leading to research recommendations intended to improve the management of DV in children and adults are summarized. Results: To improve the management of DV in children and adults, the TT panel proposed: (1) to conduct reliable prevalence studies of DV; (2) to perform longitudinal studies to prospectively test the sequence hypothesis by answering the following questions: (a) Which, if any children show a progression from overactive bladder or voiding postponement to DV?; (b) Which children develop each disorder without precursors?; and (c) Is there a continuation of DV from childhood to adulthood, or are adult cases new-onset presentations?;(3) to obtain detailed information regarding psychopathology to understand which comorbid psychological disorders prevail and at which rate, in those suffering DV; (4) to develop and validate diagnostic tools specifically for DV; (5) to better establish urodynamic correlates of DV specific for different age groups; and (6) to generate prospective long-term data regarding the efficacy of different treatment options and management strategies. Conclusions: The future research recommendations of this TT may improve our management of DV in children and adults. K E Y W O R D S biofeedback, dysfunctional voiding, emptying symptoms, overactive bladder, urethral sphincter, urodynamics

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Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: A systematic review

Cited by 64 publications

References 27 publications

The effect of pelvic physiotherapy on reduction of functional constipation in children: design of a multicentre randomised controlled trial

The effect of pelvic physiotherapy on reduction of functional constipation in children: design of a multicentre randomised controlled trial

Bear‐Down Maneuver Is a Useful Adjunct in the Evaluation of Children With Chronic Constipation

Can we improve our management of dysfunctional voiding in children and adults: International Consultation on Incontinence Research Society; ICI‐RS2018?

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