Study of the Efficacy of 4 Treatments for Fecal Incontinence in Community-dwelling Women
Study of the Efficacy of Treatment of Fecal Incontinence in Community-dwelling Women: Assessment of Individual Efficacy on Anorectal Physiology and Cortical Plasticity, Its Impact on Clinical Severity and on Quality of Life.
研究概览
详细说明
Fecal incontinence is a prevalent condition with a major impact on quality of life. Currently four treatments are being used in clinical practice: Kegel exercises (K), biofeedback (BF), electrostimulation (ES) and transcutaneous neuromodulation (NM). Results in the literature are discordant and lack methodological rigour making scientific evidence weak.
The aim of this study is to assess the efficacy of these four treatments on community-dwelling women and their impact on anorectal physiology, on clinical severity and on QoL.
This is a randomized control trial. Patient physiology was studied with anorectal manometry and endoanal ultrasonography; clinical severity was assessed with Cleveland and St. Mark's scales, and QoL with the Faecal Incontinence Quality of Life (FIQL) and the EuroQol's EQ5D questionnaires. Urinary incontinence (UI) was also evaluated by means of International Consultation on Incontinence (ICIQ) score. Patients were randomized and assigned to K (control), BF+K, ES+K or NM+K, given active treatment for a 3-month period, and then evaluated again with identical tests and parameters to identify changes.
研究类型
注册 (实际的)
阶段
- 不适用
参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Age higher than 18
- To be woman
- Have had incontinence episiodes at least from 6 month since the beginning of the study
- Have had incontinence episodes during the last month prior the beginning of the study
- The patient is able to understand the nature and impliations of the study and, therefore, to decide her participation.
Exclusion Criteria:
- Not meeting inclusion criteria
- Have very mild condition (Wexner <4)
- To be unable to perform / understand the treatments properly
- Being pregnant
- To have used treatmets for fecal incontinence within the last six months prior to the start of the study
- If, at reserarcher's criteria, the patient has not the proper conditions to perform and finish the treatments.
学习计划
研究是如何设计的？
设计细节
- 主要用途：治疗
- 分配：随机化
- 介入模型：并行分配
- 屏蔽：无（打开标签）
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器：Kegel exercises
Pelvic floor exercises designed in the 1950s' by Arnold Kegel.
|
The aim is to compare how each treatment improves symptoms and quality of life and which physiologic mechanisms affects.
The basal treatment which other therapies are compared to is Kegel.
|
|
实验性的：biofeedback
Biofeeback therapy to improve neuromuscular coordination and strengthen sphincter contractility.
|
The aim is to compare how each treatment improves symptoms and quality of life and which physiologic mechanisms affects.
The basal treatment which other therapies are compared to is Kegel.
|
|
实验性的：electrostimulation
Administration of electric current with a specific device (stimulator) and through a vaginal prove, in order to improve pelvic floor contractility.
|
The aim is to compare how each treatment improves symptoms and quality of life and which physiologic mechanisms affects.
The basal treatment which other therapies are compared to is Kegel.
|
|
实验性的：transcutaneous neuromodulation
Stimulation of tibial nerve with a specific electric current through a stimulator and surface electrodes
|
The aim is to compare how each treatment improves symptoms and quality of life and which physiologic mechanisms affects.
The basal treatment which other therapies are compared to is Kegel.
|
研究衡量的是什么？
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
clinical severity
大体时间：Changes of severity after 3 month-treatment
|
severity of the symptoms measured with Cleveland score
|
Changes of severity after 3 month-treatment
|
|
maximum anal resting pressure
大体时间：Changes maximum anal resting pressure after 3 month-treatment
|
pressure of the anal canal measured with mmHg
|
Changes maximum anal resting pressure after 3 month-treatment
|
|
maximum squeeze pressure
大体时间：Changes maximum squeeze pressure after 3 month-treatment
|
pressure on the anal canal when squeezing measured with mmHg
|
Changes maximum squeeze pressure after 3 month-treatment
|
|
rectal sensitivity
大体时间：changes in rectal balloon filling after 3 month-treatment
|
patient's rectal perception, measured with cm3 of distention of a rectal balloon
|
changes in rectal balloon filling after 3 month-treatment
|
合作者和调查者
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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