The goal of this clinical trial is to learn if a combined exercise and abdominal massage program improves bowel function and daily well-being in children with functional constipation. Researchers will compare this program with standard care by measuring bowel symptoms, rectal size, pelvic floor strength, trunk endurance, and quality of life.
This clinical trial includes children with functional constipation. Participants will be randomly assigned to either a combined exercise and abdominal massage program or to standard care and education. Children in the program group will take part in guided exercise sessions and receive abdominal massage, while the standard care group will receive routine follow-up and advice on bowel habits. Researchers will measure bowel symptoms, bowel movement patterns, rectal diameter, pelvic floor muscle function, trunk muscle endurance, and quality of life before and after the program. The results may help improve safe, non-drug treatment options for children with constipation.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
Children will complete exercises to improve flexibility, muscle strength, and trunk stability.
Gentle abdominal massage will be applied following the colon pathway to support bowel movement.
Children and their parents will receive education about bowel function and lifestyle guidance on diet, fluid intake, toileting habits, and physical activity.
Ankara Bilkent City Hospital - Pediatric Surgery Clinic
Ankara, Ankara, Turkey (Türkiye)
Rectal Diameter (measured by ultrasound)
Rectal diameter will be measured using abdominal ultrasonography to assess rectal distension related to functional constipation. Measurements will be performed before the intervention and at the end of the eight-week program. Changes in rectal diameter will be used to evaluate the effectiveness of the combined exercise and abdominal massage program.
Time frame: Baseline and after eight weeks
Constipation Symptoms (Rome IV Diagnostic Criteria)
Constipation symptoms will be assessed using the Rome IV diagnostic criteria for functional constipation, including bowel movement frequency, fecal incontinence, painful or difficult defecation, stool withholding behavior, and presence of large stools.
Time frame: Baseline and after eight weeks
Bowel Function (Bowel Diary + Bristol Stool Scale)
Bowel function will be evaluated using a 7-day bowel diary including stool frequency and stool consistency (Bristol Stool Scale, Types 1-7). The diary will be completed for one week at baseline and for one week after the 8-week program.
Time frame: Baseline and after eight weeks
Pelvic Floor Function
Pelvic floor muscle function will be evaluated using the Oxford Scale adapted for children. Muscle contraction strength will be graded during a clinical assessment.
Time frame: Baseline and after eight weeks
Quality of Life (Visual Analog Scale)
Children's and parents' quality of life will be measured using a Visual Analog Scale ranging from zero to ten, with higher scores indicating greater impact of constipation on daily life.
Time frame: Baseline and after eight weeks
Perceived Improvement (9-Point Patient Global Impression of Change Scale)
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Children will practice fast and slow pelvic floor contractions to improve muscle strength and endurance.
Children will perform simple diaphragmatic breathing exercises daily to support abdominal and pelvic muscle coordination.
Perceived improvement will be evaluated using the 9-point Patient Global Impression of Change Scale. Parents will rate their child's overall change in constipation symptoms compared to the start of the study, with higher scores indicating greater improvement.
Time frame: After eight weeks
Treatment Adherence (Visual Analog Scale)
Adherence to treatment recommendations will be evaluated using a Visual Analog Scale completed by parents, with higher scores indicating better adherence.
Time frame: After eight weeks