Improvement of Fecal Incontinence and Quality of Life by Electrical Stimulation and Biofeedback for Patients with Low Rectal Cancer after Intersphincteric Resection

Li Jen Kuo, Yu-Ching Lin, Chien Hung Lai, Yen Kuang Lin, Yu Shih Huang, Chia Chen Hu, Shih Ching Chen

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Objective To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. Design Prospective, observational study. Setting University hospital physiotherapy clinics. Participants Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study. Interventions Pelvic rehabilitation programs included electrical stimulation (ES) and biofeedback (BF). Main Outcome Measures Functional results, Wexner score, and anorectal manometry were used to assess the clinical outcomes of rehabilitation treatment. Results Maximum squeeze pressure improved after rehabilitation training (P=.014). There were no statistical differences in resting pressure, resting muscle electromyography, and maximum squeeze electromyography (P=.061, P=.76, and P=.99, respectively). The mean stool frequency was 18.8 per 24 hours before the pelvic intervention program and 7.8 per 24 hours after ES and BF training (P<.001). Of the 32 patients, 27 required antidiarrheal medications before treatment, and after completion of the training, only 9 patients still needed antidiarrheal medications (P<.001). Significant improvements were observed in the Wexner score (17.74 vs 12.93; P<.001). Conclusions Our data show that ES and BF are effective in the treatment of fecal incontinence, leading to improvement of quality of life for patients with low rectal cancer after ISR.

Original languageEnglish
Pages (from-to)1442-1447
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Volume96
Issue number8
DOIs
Publication statusPublished - 2015 Jan 1
Externally publishedYes

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Fecal Incontinence
Rectal Neoplasms
Electric Stimulation
Quality of Life
Antidiarrheals
Rehabilitation
Electromyography
Pressure
Defecation
Manometry
Observational Studies
Appointments and Schedules
Therapeutics
Outcome Assessment (Health Care)
Prospective Studies
Muscles

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Kuo, Li Jen ; Lin, Yu-Ching ; Lai, Chien Hung ; Lin, Yen Kuang ; Huang, Yu Shih ; Hu, Chia Chen ; Chen, Shih Ching. / Improvement of Fecal Incontinence and Quality of Life by Electrical Stimulation and Biofeedback for Patients with Low Rectal Cancer after Intersphincteric Resection. In: Archives of Physical Medicine and Rehabilitation. 2015 ; Vol. 96, No. 8. pp. 1442-1447.
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abstract = "Objective To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. Design Prospective, observational study. Setting University hospital physiotherapy clinics. Participants Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study. Interventions Pelvic rehabilitation programs included electrical stimulation (ES) and biofeedback (BF). Main Outcome Measures Functional results, Wexner score, and anorectal manometry were used to assess the clinical outcomes of rehabilitation treatment. Results Maximum squeeze pressure improved after rehabilitation training (P=.014). There were no statistical differences in resting pressure, resting muscle electromyography, and maximum squeeze electromyography (P=.061, P=.76, and P=.99, respectively). The mean stool frequency was 18.8 per 24 hours before the pelvic intervention program and 7.8 per 24 hours after ES and BF training (P<.001). Of the 32 patients, 27 required antidiarrheal medications before treatment, and after completion of the training, only 9 patients still needed antidiarrheal medications (P<.001). Significant improvements were observed in the Wexner score (17.74 vs 12.93; P<.001). Conclusions Our data show that ES and BF are effective in the treatment of fecal incontinence, leading to improvement of quality of life for patients with low rectal cancer after ISR.",
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Improvement of Fecal Incontinence and Quality of Life by Electrical Stimulation and Biofeedback for Patients with Low Rectal Cancer after Intersphincteric Resection. / Kuo, Li Jen; Lin, Yu-Ching; Lai, Chien Hung; Lin, Yen Kuang; Huang, Yu Shih; Hu, Chia Chen; Chen, Shih Ching.

In: Archives of Physical Medicine and Rehabilitation, Vol. 96, No. 8, 01.01.2015, p. 1442-1447.

Research output: Contribution to journalArticle

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AU - Kuo, Li Jen

AU - Lin, Yu-Ching

AU - Lai, Chien Hung

AU - Lin, Yen Kuang

AU - Huang, Yu Shih

AU - Hu, Chia Chen

AU - Chen, Shih Ching

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N2 - Objective To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. Design Prospective, observational study. Setting University hospital physiotherapy clinics. Participants Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study. Interventions Pelvic rehabilitation programs included electrical stimulation (ES) and biofeedback (BF). Main Outcome Measures Functional results, Wexner score, and anorectal manometry were used to assess the clinical outcomes of rehabilitation treatment. Results Maximum squeeze pressure improved after rehabilitation training (P=.014). There were no statistical differences in resting pressure, resting muscle electromyography, and maximum squeeze electromyography (P=.061, P=.76, and P=.99, respectively). The mean stool frequency was 18.8 per 24 hours before the pelvic intervention program and 7.8 per 24 hours after ES and BF training (P<.001). Of the 32 patients, 27 required antidiarrheal medications before treatment, and after completion of the training, only 9 patients still needed antidiarrheal medications (P<.001). Significant improvements were observed in the Wexner score (17.74 vs 12.93; P<.001). Conclusions Our data show that ES and BF are effective in the treatment of fecal incontinence, leading to improvement of quality of life for patients with low rectal cancer after ISR.

AB - Objective To assess the efficacy and benefits of pelvic rehabilitation programs in terms of functional outcomes and quality of life for patients with fecal incontinence and defecation disorders after rectal cancer surgery. Design Prospective, observational study. Setting University hospital physiotherapy clinics. Participants Patients (N=32) who experienced fecal incontinence after sphincter-saving surgery with the intersphincteric resection (ISR) technique and could follow and cooperate with the treatment schedule were included in the present study. Interventions Pelvic rehabilitation programs included electrical stimulation (ES) and biofeedback (BF). Main Outcome Measures Functional results, Wexner score, and anorectal manometry were used to assess the clinical outcomes of rehabilitation treatment. Results Maximum squeeze pressure improved after rehabilitation training (P=.014). There were no statistical differences in resting pressure, resting muscle electromyography, and maximum squeeze electromyography (P=.061, P=.76, and P=.99, respectively). The mean stool frequency was 18.8 per 24 hours before the pelvic intervention program and 7.8 per 24 hours after ES and BF training (P<.001). Of the 32 patients, 27 required antidiarrheal medications before treatment, and after completion of the training, only 9 patients still needed antidiarrheal medications (P<.001). Significant improvements were observed in the Wexner score (17.74 vs 12.93; P<.001). Conclusions Our data show that ES and BF are effective in the treatment of fecal incontinence, leading to improvement of quality of life for patients with low rectal cancer after ISR.

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