Functional constipation is a common childhood problem often related to pelvic floor muscle dysfunction.
Dr Marieke van Engelenburg-van Lonkhuyzen and colleagues compared the effectiveness of pelvic physiotherapy vs standard medical care in children with functional constipation.
The research team performed a multicenter randomized controlled trial of 53 children with functional constipation according to the Rome III criteria, at hospitals in The Netherlands from 2009 to 2014.
Group allocation was concealed using a central computer system.
Standard medical care consisted of education, toilet training, and laxatives, whereas pelvic physiotherapy included standard medical care plus specific physiotherapeutic interventions.
|Treatment success was achieved for 89% of subjects receiving pelvic physiotherapy|
The team obtained results from written reports from the subjects’ pediatricians and parents.
The researchers' primary outcome was absence of functional constipation, according to Rome III criteria, after a 6-month follow-up period.
Secondary outcomes were global perceived effect, numeric rating scales assessing quality of life, and the strengths and difficulties questionnaire.
The team noted that treatment was effective for 92% of the children receiving pelvic physiotherapy, and for 63% of the children receiving standard medical care.
Significantly more children undergoing pelvic physiotherapy stopped using laxatives.
The research team observed that treatment success was achieved for 89% of subjects receiving pelvic physiotherapy vs 33% of subjects receiving standard medical care.
Pelvic physiotherapy also produced larger adjusted mean differences, before vs after treatment, in numeric rating scales to assess quality of life, an increase of 1.8 points for parents, and 2 points for children.
The team found that results from the strengths and difficulties questionnaire did not differ significantly between groups.
Dr van Engelenburg-van Lonkhuyzen's team comments, "In a randomized controlled trial of children with functional constipation, pelvic physiotherapy was more effective than standard medical care on all outcomes measured, with the exception of findings from the strengths and difficulties questionnaire."
"Pelvic physiotherapy should be considered as a treatment option for functional constipation in children 5–16 years old."