Biofeedback-guided pelvic floor exercise therapy for obstructive defecation: An effective alternative

Table 1 Clinical, physiologic, and psychological characteristics of biofeedback pelvic floor training and polyethylene glycol groups

Baseline	BFT	PEG
n	44	44
Age (yr)	54	57
Symptoms	6.4	6.6
Physician visits (past six months)	3.1	3.3
Mean duration of disease (yr)	3.5	3.6
Previous treatment Times (yr)	2.3	2.6
First sensation (mL)	19.3	18.7
Rest pressure (mm Hg)	38	40
Squeeze pressure (mm Hg)	63	61
Wexner constipation score	29 ± 3.9	30 ± 4.3
Quality of life score	42 ± 2.9	43 ± 3.2

BFT: Biofeedback pelvic floor training; PEG: Polyethylene glycol.

Table 2 Wexner Constipation Score system[23] (Minimum score 0; maximum score 30)[24]

Frequency of bowel movements	Score
1-2 times per 1-2 d	0
2 times per week	1
Once per week	2
Less than once per week	3
Less than once per month	4
Difficulty: painful evacuation effort	Score
Never	0
Rarely	1
Sometimes	2
Usually	3
Always	4
Completeness: (feeling incomplete evacuation)	Score
Never	0
Rarely	1
Sometimes	2
Usually	3
Always	4
Failure: (unsuccessful attempts at evacuation per 24 h)	Score
Never	0
1-3	1
3-6	2
6-9	3
More than 9	4
Pain: abdominal	Score
Never	0
Rarely	1
Sometimes	2
Usually	3
Always	4
Time: minutes in lavatory per attempt	Score
Less than 5	0
5-10	1
10-20	2
20-30	3
More than 30	4
History: duration of constipation (yr)	Score
0	0
1-5	1
5-10	2
10-20	3
More than 20	4
Assistance: type of assistance	Score
Without assistance	0
Stimulant laxatives	1
Digital assistance/enema	2

Table 3 Comparison of biofeedback pelvic floor training and polyethylene glycol groups at each follow-up time after treatment n (%)

Symptoms	PEG	BFT	Statistic value	P value
Difficult evacuation
1-mo follow-up	39 (88.64)	31 (70.45)	4.4698	0.0345
3-mo follow-up	31 (70.45)	18 (40.90)	8.0173	0.0046
6-mo follow-up	24 (54.54)	11 (25.00)	8.0173	0.0046
Hard stools
1-mo follow-up	34 (77.27)	28 (63.64)	1.9653	0.1610
3- mo follow-up	29 (65.91)	10 (22.73)	16.6238	0.0000
6- mo follow-up	21 (47.73)	7 (15.91)	10.2667	0.0014
Need for digitation
1-mo follow-up	31 (70.45)	7 (15.55)	26.6779	0.0000
3-mo follow-up	25 (56.82)	5 (11.36)	20.2299	0.0000
6-mo h follow-up	20 (45.45)	3 (6.82)	17.0114	0.0000
Sensation of incomplete emptying
1-mo follow-up	28 (63.64)	15 (34.09)	7.6858	0.0056
3-mo follow-up	21 (47.73)	18 (40.90)	6.4144	0.5197
6-mo follow-up	14 (31.82)	10 (22.73)	0.9167	0.3384
Laxative dependence
1-mo follow-up	37 (84.09)	25 (56.82)	7.8610	0.0051
3-mo follow-up	31 (70.45)	19 (43.18)	6.6695	0.0098
6-mo follow-up	28 (63.64)	10 (22.73)	15.0063	0.0001
Perianal pain at defecation
1-mo follow-up	28 (63.64)	12 (27.27)	11.7333	0.0006
3-mo follow-up	24 (54.54)	15 (34.09)	3.7300	0.0534
6-mo follow-up	18 (40.91)	9 (20.45)	4.3279	0.0375
Satisfaction
1-mo follow-up	8 (18.18)	19 (42.22)	6.4651	0.0110
3-mo follow-up	11 (25.00)	25 (56.81)	9.2137	0.0024
6-mo follow-up	9 (20.45)	35 (79.54)	7.0625	0.0010

PEG: Polyethylene glycol; BFT: Biofeedback-guided pelvic floor exercise therapy.

Table 4 Comparison of biofeedback pelvic floor training and polyethylene glycol groups wexner scores and quality of life scores

	Symptoms (mo)	PEG	BFT	Statistic value	P value
Wexner scores	1	16 ± 4.1	22 ± 4.2	14.518	0
	3	18 ± 3.9	23 ± 3.2	29.3749	0
	6	19 ± 3.4	25 ± 3.1	68.2902	0
Quality of life scores	1	50 ± 2.5	62 ± 3.8	16.4269	0
	3	57 ± 2.1	71 ± 3.2	22.5295	0
	6	64 ± 1.9	80 ± 2.2	36.5105	0

BFT: Biofeedback pelvic floor training; PEG: Polyethylene glycol.