The aim of our study is to investigate the effects of physiotherapy in children with Hirschsprung's disease who have bowel symptoms after surgery.
Hirschsprung's disease is a developmental disorder of the enteric nervous system characterized by the absence of ganglion cells in the distal intestine, resulting in functional intestinal obstruction. The treatment applied after diagnosis is surgical. Although individuals with a history of surgery due to Hirschsprung's disease generally have normal bowel and urinary function, it has been reported that they have a higher prevalence of fecal incontinence and constipation and a lower quality of life related to the gastrointestinal system. However, there are few studies evaluating the use of physiotherapy in the management of postoperative bowel symptoms in children with Hirschsprung's disease.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
20
The treatment program will include patient education, lifestyle recommendations, breathing exercises, pelvic floor muscle training, and stabilization exercises. The treatment program will last for a total of 8 weeks.
Bowel function
Bowel function will be evaluated with a bowel diary. They will be asked to keep a bowel diary for 1 week, including the number and type of daily stools and the number of incontinent stools.
Time frame: before and after treatment (8-week change)
Constipation
Children's constipation will be evaluated with the Rome IV criteria. These criteria include; two or less defecation per week, fecal incontinence at least once a week, history of holding/ delaying the large toilet, painful and difficult bowel movements, presence of large feces in the rectum, presence of a history of large feces that can block the toilet. An increase in the number of symptoms indicates the severity of constipation.
Time frame: before and after treatment (8-week change)
Pelvic floor muscle function
Pelvic floor muscle function will be evaluated with palpation form anus. The presence of correct contraction and relaxation of the pelvic floor muscle will be determined.
Time frame: before and after treatment (8-week change)
Life quality
Life quality will be assessed with the Pediatric Quality of Life Inventory (PedsQL). The PedsQL consists of 23 items. It are scored between 0-100. The higher the total score of the life quality, the better health-related life quality is perceived.
Time frame: before and after treatment (8-week change)
Perception of improvement
Subjective perception of improvement will be assessed as -1 (worse), 0 (no change) and 1 (better).
Time frame: after treatment (8-week change)
Compliance with recommendations
Compliance with post-treatment recommendations will be assessed with the Visual Analog Scale (VAS). The VAS is a horizontal line with "0" at one end as "never compliance" and '10' at the other end as "always compliance".
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Time frame: after treatment (8-week change)