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 17 June 2018

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Pelvic physiotherapy in children with functional constipation

The latest issue of Gastroenterology examines the effectiveness of pelvic physiotherapy in children with functional constipation compared with standard medical care.

News image

Functional constipation is a common childhood problem often related to pelvic floor muscle dysfunction. 

Dr Marieke van Engelenburg-van Lonkhuyzen and colleagues from the Netherlands compared the effectiveness of pelvic physiotherapy vs standard medical care in children with functional constipation.

The researchers 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. 
Treatment was effective for 92% of the children receiving pelvic physiotherapy
Gastroenterology

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. 

The team obtained results from written reports from the subjects’ pediatricians and parents. 

The researcher's 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 (SDQ).

Treatment was effective for 92% of the children receiving pelvic physiotherapy, and for 63% of the children receiving standard medical care. 

The team found that 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.

The team noted an increase of 1.8 points for parents, and 2.0 points for children. 

The research team found that results from the SDQ did not differ significantly between groups.

Dr van Engelenburg-van Lonkhuyzen's team concludes, "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 SDQ."

"Pelvic physiotherapy should be considered as a treatment option for functional constipation in children 5–16 years old."

Gastroenterol 2017: 152(1): 82–91
10 January 2017

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