PELVIC FLOOR MUSCLE EXERCISE AND PHYSICAL THERAPY MAY IMPROVE SYSTEMIC SCLEROSIS-ASSOCIATED FECAL INCONTINENCE

Neslihan Gokcen

doi:10.47316/cajmhe.2021.2.2.06

Abstract

Gastrointestinal involvement in systemic sclerosis (SSc) is observed in up to 90% of patients. Resolution of some of these gastrointestinal complications is challenging without the support of physical therapy and rehabilitation. One of these complications, SSc-associated fecal incontinence, which can be devastating for those affected, is seen in up to 39%. Studies focusing on fecal incontinence and its treatment are scarce. The hypothesis presented herein suggests that pelvic floor muscle exercise, biofeedback therapy, and neuromodulation methods might be effective and safe treatment strategies for patients affected by this debilitating complication.

Highlights

Physical therapy has been part of the management of rheumatological diseases, and it has been recently included in the updated recommendations
The hypothesis presented suggests that pelvic floor muscle exercise, biofeedback therapy, and neuromodulation methods might be effective and safe treatment strategies for patients affected by this debilitating complication
Even though several studies have investigated the efficacy of exercise and rehabilitation in orofacialmusculoskeletal involvement, research evaluating interventions to improve dysfunction related to internal organ involvement remains scarce [4]

Summary

INTRODUCTION

Physical therapy has been part of the management of rheumatological diseases, and it has been recently included in the updated recommendations. Gastrointestinal involvements, consisting of microstomia, dysphagia, hoarseness, gastroesophageal reflux disease, nausea, vomiting, diarrhea, constipation, internal anal sphincter dysfunction, fecal incontinence and malabsorption, have been reported in up to 90% of SSc patients Some of these complications are difficult to overcome without the support of physical therapy and rehabilitation [5]. HYPOTHESIS Physical therapy and rehabilitation programs containing pelvic floor muscle training, pelvic floor and anorectal biofeedback therapies, and neuromodulation methods (sacral nerve stimulation, posterior tibial nerve stimulation) might be safe, effective, and logical treatment strategies in patients with SSc-associated fecal incontinence. Among these strategies, pelvic floor muscle training is regarded as the least expensive and the most practical approach. The researchers and authors should be aware of how important statistical analysis is in every step of the study [15]

CONCLUSION

Findings

FUNDING None