Hao Jie, Remis Andréas, Tang Yaogeng, Huang Biying, Pu Yuqi, Sun Yuxiao, Yao Yao
Department of Physical Therapy and Rehabilitation, Southeast Colorado Hospital, Springfield, CO, USA.
Global Health Opportunities Program, University of Nebraska Medical Center, Omaha, NE, USA.
Pediatr Surg Int. 2025 Apr 26;41(1):125. doi: 10.1007/s00383-025-06029-3.
Functional constipation is a prevalent pediatric condition and affects the physical and psychological well-being of children. Pelvic floor physical therapy is an emerging approach to manage pelvic floor dysfunction and constipation. This review aimed to evaluate current evidence regarding the effects of pelvic floor physical therapy in children with functional constipation. Three bibliographic databases, PubMed, Embase, and Scopus, were searched from inception to April 1, 2025. Randomized controlled trials comparing the effects of pelvic floor physical therapy to conventional treatment were eligible for inclusion. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Meta-analyses were performed to determine the effects of different pelvic floor physical therapy treatment approaches. Thirteen randomized controlled trials were included, with 997 children with functional constipation. All included studies were scored four to eight on the PEDro scale, indicating fair to good quality. No adverse events related to pelvic floor physical therapy were reported. Biofeedback demonstrated no significant differences compared to control (RR: 0.91, 95% CI 0.50-1.68, p = 0.01). Other treatment approaches of pelvic floor physical therapy demonstrated some positive outcomes, including therapeutic exercise, manual therapy, electrical stimulation, and multimodal treatment. Compared to conventional treatment, these treatments demonstrated significantly increased defecation frequency (MD: 1.89, 95% CI 1.30-2.47, p < 0.001), reduced painful defecation (RR: 0.69, 95% CI 0.54-0.89, p = 0.004), enhanced quality of life (SMD: 1.14, 95% CI 0.26-2.01, p = 0.01), and reduced fecal incontinence (RR: 0.59, 95% CI 0.46-0.74, p < 0.001). Pelvic floor physical therapy is feasible and effective in mitigating symptoms and improving the quality of life for children with functional constipation. Medical providers may consider pelvic floor physical therapy as an adjunctive intervention for children with functional constipation to advance the quality of care.
功能性便秘是一种常见的儿科疾病，会影响儿童的身心健康。盆底物理治疗是一种新兴的治疗盆底功能障碍和便秘的方法。本综述旨在评估目前关于盆底物理治疗对功能性便秘儿童疗效的证据。检索了三个文献数据库，即PubMed、Embase和Scopus，检索时间从建库至2025年4月1日。比较盆底物理治疗与传统治疗效果的随机对照试验符合纳入标准。采用物理治疗证据数据库（PEDro）量表评估方法学质量。进行荟萃分析以确定不同盆底物理治疗方法的效果。纳入了13项随机对照试验，共997名功能性便秘儿童。所有纳入研究在PEDro量表上的得分在4至8分之间，表明质量为中等至良好。未报告与盆底物理治疗相关的不良事件。生物反馈与对照组相比无显著差异（RR：0.91，95%CI 0.50-1.68，p = 0.01）。盆底物理治疗的其他治疗方法显示出一些积极结果，包括治疗性运动、手法治疗、电刺激和多模式治疗。与传统治疗相比，这些治疗方法显著增加了排便频率（MD：1.89，95%CI 1.30-2.47，p < 0.001），减少了排便疼痛（RR：0.69，95%CI 0.54-0.89，p = 0.004），提高了生活质量（SMD：1.14，95%CI 0.26-2.01，p = 0.01），并减少了大便失禁（RR：0.59，95%CI 0.46-0.74，p < 0.001）。盆底物理治疗在减轻功能性便秘儿童的症状和提高生活质量方面是可行且有效的。医疗服务提供者可考虑将盆底物理治疗作为功能性便秘儿童的辅助干预措施，以提高护理质量。
