The effectiveness of physiotherapy interventions on fecal incontinence and quality of life following colorectal surgery: a systematic review and meta‑analysis of randomized controlled trials

Ming Yan Pun, Leung Pak Ho, Chan Tsz Ching, Chun Pang, Kin Hei Chan, Priya Kannan (Corresponding Author)

Research output: Journal article publicationReview articleAcademic researchpeer-review

Abstract

Purpose: To investigate the effectiveness of physiotherapy interventions compared to control conditions on fecal incontinence (FI) and quality of life (QoL) following colorectal surgery. Methods: Electronic searches in English-language (Scopus, Web of Science, Embase, AMED, CENTRAL, CINAHL, MEDLINE, Ovid, and PEDro) and Chinese-language (CNKI, Wanfang Data) databases were conducted. Trials comparing physiotherapy interventions against control conditions and assessing FI and QoL outcomes were included in the review. Results: Ten trials were included. Meta-analysis revealed statistically significant improvements in lifestyle (0.54; 95% CI 0.03, 1.05; p = 0.04), coping behavior (MD 1.136; 95% CI 0.24, 2.04; p = 0.01), and embarrassment (0.417; 95% CI 0.14, 0.70; p = 0.00) components of QoL among individuals receiving pelvic floor muscle training (PFMT) compared with those receiving usual care (UC). Meta-analysis showed biofeedback to be significantly more effective than UC in enhancing anal resting pressure (ARP; 9.551; 95% CI 2.60, 16.51; p = 0.007), maximum squeeze pressure (MSP; 25.29; 95% CI 4.08, 48.50; p = 0.02), and rectal resting pressure (RRP; 0.51; 95% CI 0.10, 0.9; p = 0.02). Meta-analysis also found PFMT combined with biofeedback to be significantly more effective than PFMT alone for ARP (3.00; 95% CI 0.40, 5.60; p = 0.02), MSP (9.35, 95% CI 0.17, 18.53; p = 0.05), and RRP (1.54; 95% CI 0.60, 2.47; p = 0.00). Conclusions: PFMT combined with biofeedback was more effective than PFMT alone, but both interventions delivered alone were superior to UC. Future studies remain necessary to optimize and standardize the PFMT parameters for improving QoL among individuals who experience FI following CRC surgery. Review registration: This systematic review is registered in the PROSPERO registry (Ref: CRD42022337084).

Original languageEnglish
Article number103
JournalSupportive Care in Cancer
Volume32
Issue number2
DOIs
Publication statusPublished - Feb 2024

Keywords

  • Biofeedback
  • Colorectal cancer
  • Colorectal surgery
  • Fecal incontinence
  • Pelvic floor muscle training
  • Physiotherapy
  • Quality of life

ASJC Scopus subject areas

  • Oncology

Fingerprint

Dive into the research topics of 'The effectiveness of physiotherapy interventions on fecal incontinence and quality of life following colorectal surgery: a systematic review and meta‑analysis of randomized controlled trials'. Together they form a unique fingerprint.

Cite this