Leite Fernando Rocha, Lima Marcílio José Rodrigues de, Lacerda-Filho Antônio
Instituto Mineiro Especializado em Gastroenterologia.
Arq Gastroenterol. 2013 Jul-Sep;50(3):163-9. doi: 10.1590/S0004-28032013000200029.
Biofeedback has been used successfully in the treatment of fecal incontinence, working mainly on rehabilitation of the sphincter muscle. However, there are few studies presenting objective results of biofeedback, in terms of functional results and those related to the quality of life.
The aims of this study was to evaluate the immediate results of biofeedback in the treatment of fecal incontinence and its impact on the quality of life of patients by using validated questionnaires, correlating the results with those related to functional parameters of quality of life and clinical variables.
We analyzed and compared the results of biofeedback in 52 patients with fecal incontinence before the start of the sessions and immediately after the end of them, by applying validated questionnaires assessing the degree of intensity of fecal incontinence (FISI - Fecal Incontinence Severity Index) and evaluation of quality of life related to fecal incontinence (FIQL - Faecal Incontinence Quality of Life Scale) as compared to clinical variables (age, onset of symptoms, etiology of the fecal incontinence, number of sessions of biofeedback and number and types of deliveries).
The evaluation of the results of FISI showed a significant increase in the number of individuals who had low severity scores of symptoms before and after the biofeedback (from 48.1 to 65.4%) with P = 0.004. There was significant improvements in domains of the FIQL, behavior (P = 0.008), depression (P = 0.006) and embarrassment (P = 0.008) after biofeedback. There was no significant correlation between the improvement of functional parameters evaluated by FISI and the improvement of quality of life. Positive correlation was found between the improvements of the domains of FIQL. There was no significant correlation between the results obtained using the FISI and FIQL with clinical variables assessed.
Biofeedback has proven to be an effective therapy in the treatment of fecal incontinence, improving symptoms and/or quality of life for most patients, regardless of clinical presentation of this functional disorder.
生物反馈已成功应用于大便失禁的治疗，主要作用于括约肌肌肉的康复。然而，就功能结果及与生活质量相关的结果而言，很少有研究呈现生物反馈的客观结果。
本研究的目的是通过使用经过验证的问卷，评估生物反馈治疗大便失禁的即时结果及其对患者生活质量的影响，将结果与生活质量功能参数及临床变量相关联。
我们通过应用经过验证的问卷，评估大便失禁的严重程度（FISI - 大便失禁严重程度指数）以及与大便失禁相关的生活质量（FIQL - 大便失禁生活质量量表），并与临床变量（年龄、症状发作、大便失禁的病因、生物反馈治疗的疗程数以及分娩次数和类型）进行比较，分析并比较了52例大便失禁患者在生物反馈治疗开始前和结束后立即进行生物反馈治疗的结果。
FISI结果评估显示，生物反馈治疗前后症状严重程度得分较低的个体数量显著增加（从48.1%增至65.4%），P = 0.004。生物反馈治疗后，FIQL的行为（P = 0.008）、抑郁（P = 0.006）和尴尬（P = 0.008）领域有显著改善。FISI评估的功能参数改善与生活质量改善之间无显著相关性。FIQL各领域的改善之间存在正相关。使用FISI和FIQL获得的结果与评估的临床变量之间无显著相关性。
生物反馈已被证明是治疗大便失禁的有效疗法，可改善大多数患者的症状和/或生活质量，无论这种功能障碍的临床表现如何。
