The Effect of Pelvic Floor Muscle Training in Functional Constipation

Summary

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.

Conditions

• Pelvic Floor
• Functional Constipation
• Biofeedback
• Chronic Constipation
• Diaphragmatic Breathing

Interventions

OTHER

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.

OTHER

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.

OTHER

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.

Sponsors & Collaborators

• Selin Koşan

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

70 Years

Sex

FEMALE

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-12-22

Primary Completion

2026-05-22

Completion

2026-07-22

Countries

• Turkey (Türkiye)

Study Locations