Pelvic physiotherapy effective in treating functional constipation in children

30 Dec 2016

Pelvic physiotherapy (PPT) is superior to standard medical care (SMC) in the treatment of children with functional constipation, according to the results of a trial.

The study population comprised 53 children with functional constipation aged 5 to 16 years. These patients were randomly assigned to the PPT (n=27) or SMC intervention (n=26). SMC involved education, toilet training and laxatives. On the other hand, PPT included SMC with the addition of specific physiotherapeutic interventions.

The primary endpoint was absence of FC (as assessed by Rome III criteria) after a 6-month follow-up period. Secondary endpoints included global perceived effect (range, 1 to 9; with success designated as a score of ≥8), numeric rating scales evaluating quality of life (parent and child; scale, 1 to 10), and the strengths and difficulties questionnaire (SDQ).

Treatment was effective for 92.3 percent of children in the PPT group and for 63 percent of those in the SMC group (adjusted odds ratio [OR] for PPT success, 11.7; 95 percent CI, 1.8 to 78.3; p=0.011).

The proportion of patients who discontinued laxatives was significantly higher in the PPT group than in the SMC group (adjusted OR, 6.5; 1.6 to 26.4; p=0.009).

Furthermore, there were significantly more patients receiving PPT who achieved treatment success based on global perceived effect than there were in the SMC group (88.5 vs 33.3 percent; p<0.001).

Adjusted mean differences from baseline in numeric rating scales to assess quality of life were significantly different between the two interventions, in favour of PPT (1.8 points for parents; p=0.047 and 2.0 points for children; p=0.028).

SDQ results were similar between the PPT and SMC groups (p=0.78).

Given the effect of PPT vs SMC on all outcomes measured, with the exception of SDQ, PPT should be considered as a treatment option for functional constipation in children aged 5 to 16 years old, researchers said.

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