Universidade Federal de Pernambuco, Recife, Brasil.
Colorectal Dis. 2013 May;15(5):e250-5. doi: 10.1111/codi.12160.
The effect of muscular training, abdominal massage and diaphragmatic breathing was compared with medical treatment in a prospective randomized trial of patients with chronic functional constipation.
Patients aged 4-18 years old with functional constipation according to the Rome III criteria were randomized to physiotherapy or medical treatment. In the physiotherapy group, exercises (isometric training of the abdominal muscles, diaphragmatic breathing exercises and abdominal massage) were employed during 12 40-min sessions twice a week by a trained physiotherapist, with laxatives. Patients in the medication group were only given laxatives. Primary outcome measures were frequency of defaecation and faecal incontinence. The analysis was performed by intention-to-treat.
After 6 weeks of treatment, the frequency of bowel movements was higher in the physiotherapy group [5.1 (2.1) days/week] than in the medication group [3.9 (2.0) days/week] (P = 0.01). The frequency of faecal incontinence was no different between the groups [3.6 (1.9) days/week vs 3.0 (2.1) days/week] (P = 0.31).
The combined use of isometric training of abdominal muscles, breathing exercises and abdominal massage increased defaecation frequency after 6 weeks but faecal incontinence remained unchanged. Physiotherapy may be a useful treatment for constipation.
在一项针对慢性功能性便秘患者的前瞻性随机试验中，比较了肌肉训练、腹部按摩和膈式呼吸与药物治疗的效果。
根据罗马 III 标准，将年龄在 4-18 岁的功能性便秘患者随机分为物理治疗组或药物治疗组。在物理治疗组中，由经过培训的物理治疗师进行 12 次 40 分钟的课程，包括等长训练腹肌、膈式呼吸练习和腹部按摩，同时使用泻药。药物治疗组仅使用泻药。主要观察指标为排便频率和粪便失禁。分析采用意向治疗。
治疗 6 周后，物理治疗组的排便频率高于药物治疗组[5.1（2.1）天/周]（P=0.01）。粪便失禁的频率在两组之间没有差异[3.6（1.9）天/周 vs 3.0（2.1）天/周]（P=0.31）。
经过 6 周的治疗，等长训练腹肌、呼吸练习和腹部按摩的联合使用增加了排便频率，但粪便失禁没有改变。物理治疗可能是治疗便秘的一种有效方法。
