Effects of Different Physiotherapy Programs on Functional Constipation
Condition: Functional Constipation
MeSH terms: Constipation
Study type: Interventional

Summary: 
      This study compares the effectiveness of a more comprehensive behavioral treatment, physical
      activity and exercise program, as well as CTM and IF current stimulation approaches at
      different frequencies on functional constipation symptoms and quality of life, compared to
      their counterparts in the literature.
    

Detailed description: 
      Functional constipation (FC), which is characterized by conditions such as excessive
      straining and difficulty in defecation, infrequent bowel movements, and incomplete
      defecation, is a common bowel disease that causes activity limitation and decrease in quality
      of life in children and adults, regardless of an organic etiology.

      In the literature, there are studies showing the effectiveness of different physiotherapy
      approaches such as behavioral therapy, exercise, neuromodulation applications, kinesiotape,
      abdominal massage in FC, and investigate and compare the effectiveness of connective tissue
      manipulation (CTM) and interferential (IF) current stimulation applied in addition to
      behavioral therapy and exercise program. But there was any study which compare the
      effectiveness of these physiotherapy methods with each other and IF current stimulation at
      different frequencies (100 Hz and 0-100 Hz). In addition, there are no randomized controlled
      studies comparing the current effects of IF applied at 100 Hz and 0-100 Hz in individuals
      with FC.

      The treatment methods to be applied in this study are behavioral therapy, physical activity
      and exercise program, CTM and IF current stimulation applied at a frequency of 100 Hz and
      0-100 Hz.

      The diagnostic method to be used is based on the Rome IV FC Criteria and the Bristol Stool
      Form Scale.
    

Intervention name(s): connective tissue manipulation; Interferential current stimulation (100 Hz frequency); Interferential current stimulation (0-100 Hz frequency); behavioural therapy; exercise program
Intervention type(s): Other; Other; Other; Other; Other
Intervention description(s): Individuals in CTM group, will sit on a stool with hips and knees flexed at 90° and their hands free on the thighs. The application will start from the basic area in the first session, and in the other sessions, the lower thoracic, scapular, inter-scapular and cervical regions will be included in the treatment as soon as possible according to the state of the vascular reaction. CTM will be applied three days a week, for four weeks.; The four electrodes (superficial, self-adhesive, 5x9 cm rectangular) coming out of the two channels will be used. Two of the electrodes will be placed bilaterally at the level of the spinal segment, T9-L2, where the sympathetic fibers of the gastrointestinal tract are innervated, in the posterior region, and the other two will be placed anteriorly on the umbilicus lateral to the abdomen. The current will be applied at the sensory level, increasing to the extent that the patient feels the current effectively but does not reveal pain, discomfort and visible muscle contractions. The application will be made to the individuals at 100 Hz frequency three days a week, for four weeks.; The four electrodes (superficial, self-adhesive, 5x9 cm rectangular) coming out of the two channels will be used. Two of the electrodes will be placed bilaterally at the level of the spinal segment, T9-L2, where the sympathetic fibers of the gastrointestinal tract are innervated, in the posterior region, and the other two will be placed anteriorly on the umbilicus lateral to the abdomen. The current will be applied at the sensory level, increasing to the extent that the patient feels the current effectively but does not reveal pain, discomfort and visible muscle contractions. The application will be made to the individuals at 0-100 Hz frequency three days a week, for four weeks.; The behavioral therapy includes patient education (description of the disease, symptoms, risk factors, treatment, defecation mechanism and informing about negative attitudes and behaviors towards defecation), lifestyle advices (diet, water consumption, fiber food, etc.), teaching effective defecation posture, timed toilet training, self-abdominal massage.
"Constipation Behavioral Therapy Booklet" will be prepared within the scope of behavioral therapy.; Exercise program consisting of physical activity, core stabilization exercises and pelvic floor muscle exercises.
"Exercise Program Booklet" will be prepared within the exercise training.
Other intervention name(s): behavioural therapy; exercise program; behavioural therapy; exercise program; behavioural therapy; exercise program
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: functional constipation; connective tissue manipulation; interferential current stimulation; exercise; behavioural therapy; conservative treatment