Evidence map›Paper›PMID 33638728›Full record

ArticleTechniques in coloproctology2021

Obstructed defecation syndrome associated with paradoxical puborectalis contraction: osteopathic treatment versus anal biofeedback. Results of a pilot study.

S Ascanelli, M Portinari, M Canella, S Solari, F Dall'Omo, S Danese, A De Troia, P Carcoforo

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Article in Techniques in coloproctology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 2 syntheses or guidelines pooled it, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

S AscanelliDepartment of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Ferrara, Italy. simona.ascanelli@unife.it.ORCID http://orcid.org/0000-0002-1423-8576
M PortinariDepartment of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Ferrara, Italy.
M CanellaSurgical Department, University Hospital, Ferrara, Ferrara, Italy.
S SolariDepartment of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Ferrara, Italy.
F Dall'OmoEuropean Institute for Osteopathic Medicine, Padua, Italy.
S DaneseDepartment of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Ferrara, Italy.
A De TroiaDepartment of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Ferrara, Italy.
P CarcoforoDepartment of Morphology, Surgery and Experimental Medicine, Section General Surgery, University of Ferrara, Ferrara, Italy.
University of Ferrara · ITEuropean Institute of Oncology · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBiofeedback is the most widespread rehabilitative therapy for the treatment of anismus after failed conservative treatment. Osteopathy represents an alternative therapy for constipation. The aim of this study was to evaluate short- and long-term results of osteopathic treatment as compared to biofeedback in patients with dyssynergic defecation.

methodsThis was a prospective cohort pilot study on 30 patients with dyssynergic defecation enrolled at the Colorectal Clinic of the University Hospital of Ferrara, Italy, from May 2015 to May 2016 and followed until May 2020. Dyssynergic defecation was defined as the inappropriate contraction of the pelvic floor or less than 20% relaxation of basal resting sphincter pressure (on anal manometry) with adequate propulsive forces during attempted defecation. Dyssynergic patients were divide into 2 treatment groups: 15 patients had osteopathy and 15 patients had biofeedback. Before and 3 months after rehabilitation treatment, all patients had anorectal manometry, defecography, and ultrasound, and were evaluated with the Cleveland Clinic Florida (CCF) constipation score, obstructed defecation syndrome (ODS) score, Colo-rectal-anal Distress Inventory (CRADI-8), Colo-rectal-anal Impact Questionnaire (CRAIQ-7), and the Brusciano Score (BS). To evaluate the efficacy of osteopathy and biofeedback in the long-term, all patients completed the above-mentioned questionnaires 5 years later via a telephone interview.

resultsThe two treatments were similarly effective in the short term with reduction in questionnaires scores, and increase in the percentage of anal sphincter release at straining at anorectal manometry in both groups. The ODS score was significantly reduced in biofeedback group (p = 0.021). The 3-month post-treatment BS was lower in the osteopathy group, but this just failed to reach statistical significance (p = 0.050). Periodic rehabilitation reinforcements were provided. The CCF constipation score decreased significantly in the osteopathy group (p = 0.023) after 5 years.

conclusionsOsteopathy is a promising treatment for dyssynergic defecation, and it can be associated with biofeedback.

Indexed as

Anal CanalPelvic FloorBiofeedback, PsychologyConstipationDefecationHumansItalyManometryPilot ProjectsProspective StudiesAnismusBiofeedbackConstipationDyssynergic defecationObstructed defecationOsteopathyParadoxical puborectalis contractionPelvic dyssynergia

Identifiers

PMID33638728
OpenAlexW3131631721

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.