The effect of postural stabilization-based pelvic floor rehabilitation in patients with chronic constipation, a randomized controlled study

This study examined the effects of postural stabilization-based pelvic floor rehabilitation on posture, diaphragm and pelvic floor control, quality of life and constipation symptoms in individuals with chronic constipation. Thirty-four people with an age range of 40,15±11,1 years participated in our study. Randomization was done randomly and the participants were divided into two groups as rehabilitation (n=17) and control (n=17). At the beginning and end of the study, all participants completed the Constipation Quality of Life Scale (PAC-QOL) to measure the effect of constipation on quality of life, Pelvic Floor Impact Questionnaire (PFIQ) to evaluate the effect of constipation on the pelvic floor, SF-36 Quality of Life Scale (Short Form) questionnaires to question the general quality of life effect, and Bristol Stool Scale questionnaire was used to determine the stool types. In addition, New York Posture Rating (NYPR) was used to assess the posture; the Respiratory Stereotype Test, Intraabdominal Pressure Regulation Test, and Diaphragm Test were applied to evaluate the functions of the diaphragm and intraabdominal pressure control; and pelvic floor muscle evaluation was done using EMG biofeedback. Then, a brochure containing stretching exercises for the lower and upper extremities and trunk muscles, created with images, was given to the participants, and they were asked to perform the exercises every other day for 3 weeks. In the rehabilitation group, postural stabilizationbased pelvic floor rehabilitation was applied for 50 minutes per day, 3 days a week, for 3 weeks, under the supervision of a physiotherapist. The rehabilitation program included manual relaxation techniques for the abdominal region, diaphragm breathing exercises, intraabdominal pressure guidance exercises, pelvic floor muscle retraining with EMG biofeedback, and postural stabilization exercises using DNS techniques. The control group was only asked to follow the home exercise brochure. In our study, while there were significant differences between the initial and final assessment in the rehabilitation group (p<0,05) in the Bristol Stool Score, NYPR, Respiratory Sterotype Test, Intra-abdominal Pressure Regulation Test, Diaphragm Test, EMG biofeedback pelvic floor muscle assessments, PAC-QOL, PFIQ, SF-36 there was no significant change in the control group. Based on the significant changes in the findings, we believe that postural stabilization-based pelvic floor rehabilitation is beneficial for chronic constipation and can be used as an alternative treatment. Keywords: Chronic Constipation; Dynamic Neuromuscular Stabilization; Pelvic Floor Rehabilitation; Physiotherapy; Postural Stabilization