Anorectal dysfunction in multiple sclerosis patients: A pilot study on the effect of an individualized rehabilitation approach.
Multiple sclerosis
St. Mark’s
fecal incontinence score
biofeedback
bowel incontinence
high resolution anorectal manometry
Journal
NeuroRehabilitation
ISSN: 1878-6448
Titre abrégé: NeuroRehabilitation
Pays: Netherlands
ID NLM: 9113791
Informations de publication
Date de publication:
2022
2022
Historique:
pubmed:
16
11
2021
medline:
9
2
2022
entrez:
15
11
2021
Statut:
ppublish
Résumé
Anorectal dysfunction (ARD), especially bowel incontinence, frequently compromises the quality of life in multiple sclerosis (MS) patients. The effect of rehabilitation procedures has not been clearly established. To determine the effect of an individualized rehabilitation approach on bowel incontinence and anorectal pressures. MS patients with ARD underwent 6-months of individually targeted biofeedback rehabilitation. High resolution anorectal manometry (HRAM) and St. Mark's Fecal Incontinence Scores (SMIS) were completed prior to rehabilitation, after 10 weeks of supervised physiotherapy, and after 3 months of self-treatment. Ten patients (50%) completed the study. Repeated measures analysis of variance (ANOVA) demonstrated significant improvement in the SMIS questionnaire over time [14.00 baseline vs. 9.70 after supervised physiotherapy vs. 9.30 after self-treatment (p = 0.005)]. No significant improvements over time were noted in any HRAM readings: maximal pressure [49.85 mmHg baseline vs. 57.60 after supervised physiotherapy vs. 60.88 after self-treatment (p = 0.58)], pressure endurance [36.41 vs. 46.89 vs. 49.95 (p = 0.53)], resting pressure [55.83, vs 52.69 vs. 51.84 (p = 0.704)], or area under the curve [230.0 vs. 520.8 vs. 501.9 (p = 0.16)]. The proposed individualized rehabilitation program supports a positive overall effect on anorectal dysfunction in MS patients.
Sections du résumé
BACKGROUND
BACKGROUND
Anorectal dysfunction (ARD), especially bowel incontinence, frequently compromises the quality of life in multiple sclerosis (MS) patients. The effect of rehabilitation procedures has not been clearly established.
OBJECTIVE
OBJECTIVE
To determine the effect of an individualized rehabilitation approach on bowel incontinence and anorectal pressures.
METHODS
METHODS
MS patients with ARD underwent 6-months of individually targeted biofeedback rehabilitation. High resolution anorectal manometry (HRAM) and St. Mark's Fecal Incontinence Scores (SMIS) were completed prior to rehabilitation, after 10 weeks of supervised physiotherapy, and after 3 months of self-treatment.
RESULTS
RESULTS
Ten patients (50%) completed the study. Repeated measures analysis of variance (ANOVA) demonstrated significant improvement in the SMIS questionnaire over time [14.00 baseline vs. 9.70 after supervised physiotherapy vs. 9.30 after self-treatment (p = 0.005)]. No significant improvements over time were noted in any HRAM readings: maximal pressure [49.85 mmHg baseline vs. 57.60 after supervised physiotherapy vs. 60.88 after self-treatment (p = 0.58)], pressure endurance [36.41 vs. 46.89 vs. 49.95 (p = 0.53)], resting pressure [55.83, vs 52.69 vs. 51.84 (p = 0.704)], or area under the curve [230.0 vs. 520.8 vs. 501.9 (p = 0.16)].
CONCLUSIONS
CONCLUSIONS
The proposed individualized rehabilitation program supports a positive overall effect on anorectal dysfunction in MS patients.
Identifiants
pubmed: 34776431
pii: NRE210226
doi: 10.3233/NRE-210226
pmc: PMC8925101
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
89-99Références
Ther Adv Urol. 2020 Jun 25;12:1756287220934359
pubmed: 32647538
Ann Coloproctol. 2019 Dec;35(6):319-326
pubmed: 31937071
Autoimmune Dis. 2011;2011:803841
pubmed: 21603189
J Clin Med. 2020 Apr 23;9(4):
pubmed: 32340194
BMC Public Health. 2007 Dec 20;7:355
pubmed: 18096041
Cochrane Database Syst Rev. 2012 Jul 11;(7):CD002111
pubmed: 22786479
J Neurol Neurosurg Psychiatry. 2000 Aug;69(2):240-3
pubmed: 10896701
Can J Gastroenterol. 2009 Apr;23(4):301-8
pubmed: 19373424
Adv Urol. 2014;2014:487436
pubmed: 25006337
Gut. 1999 Jan;44(1):77-80
pubmed: 9862829
Neurogastroenterol Motil. 2014 May;26(5):625-35
pubmed: 24628873
Int Urogynecol J. 2019 Dec;30(12):2101-2108
pubmed: 31172220
Post Reprod Health. 2020 Jun;26(2):63-70
pubmed: 32627702
Gastroenterology. 2016 Mar 25;:
pubmed: 27144630
J Neurol. 1996 Jun;243(6):445-51
pubmed: 8803816
Dis Colon Rectum. 2004 Dec;47(12):2147-56
pubmed: 15657667
BMC Neurol. 2017 Sep 16;17(1):185
pubmed: 28915856
J Neurogastroenterol Motil. 2019 Apr 30;25(2):189-204
pubmed: 30827084
Int J MS Care. 2017 Jan-Feb;19(1):42-56
pubmed: 28243186
Best Pract Res Clin Gastroenterol. 2009;23(4):531-43
pubmed: 19647688
Degener Neurol Neuromuscul Dis. 2018 Dec 06;8:79-90
pubmed: 30584387
Am J Gastroenterol. 1999 Mar;94(3):773-83
pubmed: 10086665
J Neurogastroenterol Motil. 2015 Jan 1;21(1):126-32
pubmed: 25537672
Neurogastroenterol Motil. 2013 Mar;25(3):230-7, e163
pubmed: 23130678
Curr Gastroenterol Rep. 2020 Sep 15;22(11):55
pubmed: 32935278
J Neurol. 1995 Jan;242(2):105-8
pubmed: 7707085
Am J Gastroenterol. 2012 Oct;107(10):1530-6
pubmed: 22986439
Neurourol Urodyn. 2018 Jan;37(1):46-53
pubmed: 28640977
Int J Mol Sci. 2015 Jul 24;16(8):16920-52
pubmed: 26213927
J Neurogastroenterol Motil. 2016 Jan 31;22(1):46-59
pubmed: 26717931
Open Med (Wars). 2016 Nov 25;11(1):509-517
pubmed: 28352843
Int Urogynecol J Pelvic Floor Dysfunct. 2009 Apr;20(4):407-10
pubmed: 19082774
Mult Scler. 2008 Mar;14(2):237-42
pubmed: 17942511
Eur J Phys Rehabil Med. 2010 Sep;46(3):423-38
pubmed: 20927008
Int J Sports Phys Ther. 2013 Feb;8(1):62-73
pubmed: 23439921
Dis Colon Rectum. 2011 Sep;54(9):1114-21
pubmed: 21825891
Curr Pain Headache Rep. 2010 Oct;14(5):353-60
pubmed: 20652653
Ann Phys Rehabil Med. 2018 Sep;61(5):345-351
pubmed: 30017491
Neuromodulation. 2018 Oct;21(7):682-687
pubmed: 29575432
Neurogastroenterol Motil. 2019 Jul;31(7):e13597
pubmed: 30957382
J Neurol. 2012 Sep;259(9):1994-2008
pubmed: 22772357
Mult Scler. 2006 Apr;12(2):215-8
pubmed: 16629426
Br J Community Nurs. 2006 Aug;11(8):333-4, 336-7, 340-1
pubmed: 17044245
ISRN Neurol. 2012;2012:376023
pubmed: 22900202
Am J Phys Med Rehabil. 2019 Jul;98(7):613-621
pubmed: 30844920
Int J Colorectal Dis. 1993 Dec;8(4):220-4
pubmed: 8163898
Ther Umsch. 2013 Jul;70(7):403-6
pubmed: 23798023
JGH Open. 2019 Jun 24;3(6):494-507
pubmed: 31832550
Expert Rev Gastroenterol Hepatol. 2009 Aug;3(4):417-23
pubmed: 19673628
Dis Colon Rectum. 2008 Apr;51(4):436-42
pubmed: 18219532
World J Gastroenterol. 2017 Jan 7;23(1):11-24
pubmed: 28104977
Lancet Neurol. 2017 Oct;16(10):848-856
pubmed: 28920890
Transl Androl Urol. 2017 Jul;6(Suppl 2):S64-S67
pubmed: 28791223
Neurogastroenterol Motil. 2019 Jun;31(6):e13591
pubmed: 31094054
Gastroenterology. 1990 Jun;98(6):1538-42
pubmed: 2338192