Evidence map›Paper›PMID 41961325›Full record

SynthesisEuropean journal of pediatrics2026

Efficacy of physiotherapeutic interventions in the management of functional constipation in pediatric and adolescent populations: a systematic review and meta-analysis.

Esther M Medrano-Sánchez, Marta Díaz-Gutiérrez, Paula García-Polo, Esther Diaz-Mohedo

Abstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in European journal of pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

4 authors.

Esther M Medrano-SánchezDepartamento de Fisioterapia, Universidad de Sevilla, Calle Avenzoar, 9, 41009, Sevilla, Spain. emedrano@us.es.ORCID http://orcid.org/0000-0003-4279-5852
Marta Díaz-GutiérrezPhysiotherapist, Medical Center Rubén García, Sevilla, Spain.
Paula García-PoloPhysiotherapist, Zaidafisiopelvic, Sevilla, Spain.
Esther Diaz-MohedoDepartamento de Fisioterapia, Universidad de Málaga, Avda. de Cervantes, 2, 29016, Málaga, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

To evaluate the efficacy of physiotherapeutic interventions in the management of functional constipation (FC) in pediatric and adolescent populations, and to analyze the methodological quality of the available evidence. A systematic review of randomized controlled trials (RCTs) published in PubMed, Cochrane Library, Embase, and Web of Science was conducted (February-March 2025). Studies including participants aged 18 years diagnosed with FC, treated with pelvic floor physiotherapy versus conventional medical treatment, were included. Methodological quality was assessed using the PEDro scale (Physiotherapy Evidence Database). Seven clinical trials were included in the meta-analysis with sample sizes ranging from 45 to 400 participants (total n = 775). The interventions covered pelvic floor exercises, biofeedback, telerehabilitation, visceral mobilization, and electrostimulation. The majority showed improvements in painful defecation, fecal consistency, and quality of life, with less consistent results in defecatory frequency (MD = 1.00; 95% CI: 0.35 to 1.65). However, the marked heterogeneity in protocols (type, intensity, duration), variability in assessment instruments, and frequent co-intervention with polyethylene glycol (PEG) hinder comparison between studies and limit external validity. Follow-ups shorter than 12 months and the absence of blinding of participants and therapists constitute additional risks of bias.

conclusionsPelvic floor physiotherapy appears to be a promising adjuvant intervention in the treatment of pediatric FC, with positive effects on symptoms and quality of life. Nevertheless, multicenter trials with standardized protocols, large samples, and prolonged follow-up are required to confirm its efficacy and long-term sustainability. WHAT IS KNOWN: •Despite the clinical use of physiotherapy, there was no quantitative synthesis integrating its efficacy against standard medical treatment, nor had its specific effect size on defecatory pain and quality of life been established in the pediatric population. WHAT IS NEW: •This meta-analysis confi rms that pelvic fl oor physiotherapy is an eff ective adjuvant with a large effect size, demonstrating consistent improvements in reducing painful defecation and enhancing the biopsychosocial dimensions of quality of life.

Indexed as

ConstipationPhysical Therapy ModalitiesAdolescentChildExercise TherapyHumansPelvic FloorQuality of LifeRandomized Controlled Trials as TopicTreatment OutcomeFunctional constipationPediatricsPelvic floorPhysiotherapy

Identifiers

PMID41961325
PMCPMC13068696

What OpenQuestion holds

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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.