Animated Biofeedback: An Ideal Treatment for Children With Dysfunctional Elimination Syndrome

Kajbafzadeh, Abdol‐Mohammad; Sharifi‐Rad, Lida; Ghahestani, Seyyed Mohammad; Ahmadi, Hamed; Kajbafzadeh, Majid; Mahboubi, Amir Hassan

doi:10.1016/j.juro.2011.07.118

Cited by 74 publications

(48 citation statements)

References 12 publications

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“…Furthermore, trials show a substantial lack of quality and harmonisation, resulting in heterogeneous treatment protocols and difficulties when interpreting the findings reported in the literature. Mixed results of BF treatment for constipation have been reported [24,54,57,59,60]. …”

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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“…7 Constipation was accurately evaluated, children with neurological abnormalities were excluded from analysis, and behavioral and physiological issues were not addressed.…”

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confidence: 99%

“…Kajbafzadeh et al used animated biofeedback (UrostymÔ) and measured pelvic floor activity along with abdominal muscle activity. 7 Six to 12 sessions were required. In the study by Klijn et al biofeedback was done in the patients' home and based on voiding.…”

mentioning

confidence: 99%

Current Role of Biofeedback for Pediatric Lower Urinary Tract Symptoms

McKenna

2015

Journal of Urology

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Animated Biofeedback: An Ideal Treatment for Children With Dysfunctional Elimination Syndrome

Abstract: Animated biofeedback effectively treats bowel and voiding dysfunction in children with dysfunctional voiding. Pelvic floor muscle exercises coordinate breathing and pelvic floor muscle contractions, and are beneficial in improving bowel dysfunction.

Cited by 74 publications

References 12 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

Current Role of Biofeedback for Pediatric Lower Urinary Tract Symptoms

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