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The Effect of Pelvic Floor Muscle Training in Functional Constipation

2026年5月27日 更新者：Selin Koşan

The Effect of Pelvic Floor Muscle Training on Symptoms, Core Muscle Function, and Quality of Life in Functional Constipation

The aim of this study is to examine the effect of individualized pelvic floor muscle training on symptoms, core muscle function, and quality of life in patients with functional constipation.The research is being conducted at the Department of Internal Medicine, Gastroenterology Division, Faculty of Medicine, Ege University.The study group received diaphragmatic breathing exercises, lifestyle modification training, and individualized pelvic floor muscle training, while the control group received diaphragmatic breathing exercises and lifestyle modification training. These treatments were applied to the patients for 8 weeks. Demographic information was recorded using a data record form. Frequency of bowel movements, stool types and shapes were assessed using the Bristol Stool Scale, muscle function using superficial electromyography (EMG), quality of life using the Constipation Quality of Life Scale, and severity of constipation using the Constipation Severity Scale. All assessments were repeated at weeks 4 and 8.

調査の概要

状態

積極的、募集していない

条件

介入・治療

研究の種類

介入

入学 (推定)

28

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究場所

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria:

  • Female cases diagnosed with functional constipation (according to ROMA IV criteria)
  • Over 18 years of age and under 70 years of age
  • According to ROMA IV criteria:
  • Onset of symptoms at least 6 months prior to diagnosis, and experiencing any two or more of the following symptoms in the last 12 weeks (not necessarily consecutive): a) straining during at least 25% of defecations, b) hard stools in at least 25% of defecations, c) feeling of incomplete bowel movements in at least 25% of defecations, d) feeling of anorectal blockage/obstruction in at least 25% of defecations, e) needing to empty the rectum (supporting the pelvic floor muscles), and f) fewer than three bowel movements per week
  • Very rare achievement of soft stools without laxative use
  • Having insufficient criteria for irritable bowel syndrome,
  • Ready to write in Turkish
  • Cases who have signed the informed consent form will be included in the study.

Exclusion Criteria:

  • Patients with secondary constipation (metabolic, endocrine, and neurological)
  • Patients with slow transit constipation
  • Patients with major orthopedic limitations that may affect the study
  • Patients with megacolon, pseudo-obstruction, and severe anorectal disorders (Grade 3-4 hemorrhoidal disease, anal fissure, anal fistula, anorectal abscess, pilonidal sinus, etc.)
  • Patients who have undergone pelvic floor surgery, coloproctological surgery, bridileus surgery, or similar major abdominal surgery (excluding appendectomy)
  • Patients with drug-induced constipation
  • Patients with any serious systemic disorder including heart, lung, gastrointestinal system, or uncontrolled diabetes mellitus
  • Patients with cognitive difficulties that would hinder the conduct of the study (Mini Mental Test score <24)
  • Patients with major psychiatric problems that may affect the study
  • Pregnant patients will be excluded.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか？

デザインの詳細

  • 主な目的：処理
  • 割り当て：ランダム化
  • 介入モデル：並列代入
  • マスキング：独身

武器と介入

参加者グループ / アーム
介入・治療
アクティブコンパレータ：control
The control group receives diaphragmatic breathing exercises and lifestyle modification training.
他の：Lifestyle change training
Patients are advised to increase their physical activity levels. Toilet training includes: not ignoring the urge to defecate, using correct posture during defecation, leaning forward with knees higher than hips when sitting on the toilet, and supporting the feet on a step to correct the anorectal angle. This training is supported by images. They are also instructed to use deep relaxation techniques during defecation, avoid straining, and not stay on the toilet for longer than 10 minutes. Dietary changes include: drinking a warm caffeinated beverage upon waking, having breakfast within an hour of waking, increasing daily fluid intake to 1.5-2 liters, and increasing dietary fiber to 25-30 grams daily, but doing so slowly to prevent abdominal cramps and bloating. Lifestyle changes are monitored daily. Diary entries are requested weekly for 8 weeks via mobile phone application/email.
他の：Diaphragmatic Breathing Exercise
The mechanism of constipation and the purpose of diaphragmatic breathing exercises will be explained to the patients. Patients will be instructed to begin the diaphragmatic breathing exercise in a seated position with one hand on their abdomen and the other on their chest, with their feet 20 cm above the ground. They will then inhale slowly, deeply, and gradually for 6-8 seconds, hold their breath for 10 seconds, and exhale slowly over 6-8 seconds. While inhaling deeply, they will be asked to expand their abdomen by raising their hands from their abdomen while keeping their hands on their chest stationary. Patients will be advised to perform this exercise 3 times a day (especially in the toilet) for 15 breaths each time.
実験的：pelvic floor muscle training
The functional status of the pelvic floor muscles is determined based on the results obtained from EMG data and the type of Pelvic Floor Muscle Training is determined. PTKE is applied individually, tailored to the functional status of the pelvic floor muscles. Before the exercise, patients are taught correct and effective pelvic floor muscle contraction and relaxation techniques through external palpation of the perineum and abdominal region. Patients are instructed to relax their pelvic floor muscles as if urinating or defecating while inhaling through their nose, feeling the area descend, and to contract their pelvic floor muscles as if holding back urine or stool while exhaling. Relaxing the levator ani muscle durmuscle during straining and proper breathing techniques are re-taught. The duration of pelvic floor muscle training is initially kept short and gradually increased. Under these conditions, sessions are held once a week, lasting approximately 30-45 minutes.
他の：Lifestyle change training
Patients are advised to increase their physical activity levels. Toilet training includes: not ignoring the urge to defecate, using correct posture during defecation, leaning forward with knees higher than hips when sitting on the toilet, and supporting the feet on a step to correct the anorectal angle. This training is supported by images. They are also instructed to use deep relaxation techniques during defecation, avoid straining, and not stay on the toilet for longer than 10 minutes. Dietary changes include: drinking a warm caffeinated beverage upon waking, having breakfast within an hour of waking, increasing daily fluid intake to 1.5-2 liters, and increasing dietary fiber to 25-30 grams daily, but doing so slowly to prevent abdominal cramps and bloating. Lifestyle changes are monitored daily. Diary entries are requested weekly for 8 weeks via mobile phone application/email.
他の：Diaphragmatic Breathing Exercise
The mechanism of constipation and the purpose of diaphragmatic breathing exercises will be explained to the patients. Patients will be instructed to begin the diaphragmatic breathing exercise in a seated position with one hand on their abdomen and the other on their chest, with their feet 20 cm above the ground. They will then inhale slowly, deeply, and gradually for 6-8 seconds, hold their breath for 10 seconds, and exhale slowly over 6-8 seconds. While inhaling deeply, they will be asked to expand their abdomen by raising their hands from their abdomen while keeping their hands on their chest stationary. Patients will be advised to perform this exercise 3 times a day (especially in the toilet) for 15 breaths each time.
他の：Pelvic Floor Muscle Training
The functional status of the pelvic floor muscles is determined based on the results obtained from EMG data and the type of Pelvic Floor Muscle Training is determined. PTKE is applied individually, tailored to the functional status of the pelvic floor muscles. Before the exercise, patients are taught correct and effective pelvic floor muscle contraction and relaxation techniques through external palpation of the perineum and abdominal region. Patients are instructed to relax their pelvic floor muscles as if urinating or defecating while inhaling through their nose, feeling the area descend, and to contract their pelvic floor muscles as if holding back urine or stool while exhaling. Relaxing the levator ani muscle durmuscle during straining and proper breathing techniques are re-taught. The duration of pelvic floor muscle training is initially kept short and gradually increased. Under these conditions, sessions are held once a week, lasting approximately 30-45 minutes.

この研究は何を測定していますか？

主要な結果の測定

結果測定
メジャーの説明
時間枠
Constipation Quality of Life Scale
時間枠：initially, 4th week, 8th week
The quality of life of the subjects is measured using the Constipation Quality of Life Scale. It consists of a total of 28 items: "worry/anxiety" (11 items), "physical discomfort" (4 items), "psychosocial discomfort" (8 items), and "satisfaction" (5 items). The scale score ranges from 28 to 140, with a higher score indicating a negative impact on quality of life.
initially, 4th week, 8th week
Constipation Severity Scale
時間枠：initially, 4th week, 8th week
The severity of constipation will be assessed using the Constipation Severity Scale (CSS). The CSS is a scale designed to determine the frequency, intensity, and difficulty/hardship of bowel movements. It can also be used to measure constipation symptoms. The minimum total score on the scale is "0", and the maximum is "73". Higher scores indicate greater severity of constipation symptoms.
initially, 4th week, 8th week
Electromyographic (EMG) Measurement
時間枠：initially, 4th week, 8th week
Electromyographic measurement will be used to record the bioelectrical activity generated by the internal oblique abdominals, transversus abdominis, and levator ani muscles in µV. First, patients will be asked to relax all their muscles when given the command "relax," to contract their muscles as strongly as possible when given the command "muscle," and to initiate defecation as if using a toilet when given the command "strain." Patients will be asked not to contract their abdominal, gluteal, and adductor muscles during each assessment.
initially, 4th week, 8th week
Bristol Stool Form Scale
時間枠：initially, 4th week,8th week
Stool consistency will be assessed using the Bristol Stool Form Scale. The scale is scored from 1 to 7, with lower scores indicating harder stools and higher scores indicating looser or watery stools. Types 1-2 represent hard/lumpy stools associated with constipation, whereas types 6-7 indicate loose/watery stools associated with diarrhea. Higher scores indicate worse stool consistency outcomes.
initially, 4th week,8th week

協力者と研究者

ここでは、この調査に関係する人々や組織を見つけることができます。

スポンサー

Selin Koşan

研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (実際)

2025年12月22日

一次修了 (推定)

2026年5月22日

研究の完了 (推定)

2026年7月22日

試験登録日

最初に提出

2026年5月18日

QC基準を満たした最初の提出物

2026年5月18日

最初の投稿 (実際)

2026年5月22日

学習記録の更新

投稿された最後の更新 (実際)

2026年5月29日

QC基準を満たした最後の更新が送信されました

2026年5月27日

最終確認日

2026年5月1日

詳しくは

本研究に関する用語

キーワード

その他の研究ID番号

  • 2026/05

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いいえ

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