Role of physical therapy in irritable bowel syndrome: Current strategies and prospective options

Table 1 Clinical effects of physical therapies in irritable bowel syndrome

Therapy	VAS pain	IBS-SSS	Rectal sensory threshold	fMRI activation	IBS-QOL	B-IBS	GSRS-IBS	IBS.S	Adverse events	Ref.
VNS	Baseline: 4-6; post-treatment: 1-3	Improved	-	-	Significantly improved	-	-	-	Mild adverse events only	[15,33,142,143]
TENS	Baseline: 3-9; post-treatment: 2-4	-	Significantly improved	-	-	-	-	-	NR	[39]
TMS	Baseline: 2-6; post-treatment: 1-5	-	Significantly improved	M1	-	-	-	-	Mild adverse events only	[50,157]
EA	Baseline: 2-8; post-treatment: 0-4	-	-	ACC, IC, PFC, INS, THA	-	-	-	-	NR	[75-77,158]
Spa therapy	-	-	-	-	-	-	-	-	Mild adverse events only	[96]
MOX	Baseline: 2-7; post-treatment: 0-4	Improved	-	ACC, IC, PFC	-	Significantly improved	-	-	Mild adverse events only	[16,98,101,102]
Vibrating capsule	-	-	-	-	-	-	-	-	Mild adverse events only	[145]
Biofeedback	-	Significantly improved	Improved	-	-	-	-	Significantly improved	NR	[111,112,159,160]
SCS	Baseline: 4-10; post-treatment: 1-6	Improved	-	-	-	-	-	-	Mild adverse events only	[117-119]
SNS	-	-	-	-	Significantly improved	-	Significantly improved	-	Serious adverse events reported	[127-129,146,161,162]

Adverse events were classified as “mild”, “serious”, or “not reported” according to the qualitative descriptions provided in the original studies. Quantitative incidence rates were not consistently reported and were therefore not available for summary in this table. ACC: Anterior cingulate cortex; B-IBS: Birmingham irritable bowel syndrome symptom questionnaire; CSBM: Complete spontaneous bowel movements; EA: Electroacupuncture; GSRS-IBS: Gastrointestinal Symptom Rating Scale-Irritable Bowel Syndrome; IBS.S: Self-reported irritable bowel syndrome symptom score; IBS-SSS: Irritable Bowel Syndrome Symptom Severity Score; IC: Insular cortex; INS: Insula; M1: Primary motor cortex; MOX: Moxibustion; NR: Not reported; PFC: Prefrontal cortex; SCS: Spinal cord stimulation; SNS: Sacral nerve stimulation; TENS: Transcutaneous electrical nerve stimulation; THA: Thalamus; TMS: Transcranial magnetic stimulation; VAS: Visual analogue scale; VNS: Vagus nerve stimulation.