Connective tissue manipulation and interferential currents in patients with functional constipation: A randomized controlled trial.

BACKGROUND

Functional constipation (FC) is a common condition that includes difficult, irregular bowel movements, abdominal pain, and bloating.

PURPOSE: To investigate the comparative effectiveness of connective tissue manipulation (CTM) and interferential currents (IFCs) over behavioral education and therapy (BET) on FC.

METHODS

Fifty-four patients with FC were randomly assigned into four groups. The control group received only BET, the intervention groups received CTM, IFC0-100, or IFC100 additional to the BET, 3 days/week for 4 weeks. CTM was initially applied to the lumbosacral area; in subsequent sessions, the lower thoracic, scapular, interscapular, and cervical regions were also included, respectively. Bowel function (7-day-bowel diary), constipation severity (Constipation Severity Instrument), and QoL (Patient Assessment of Constipation Quality of Life) were assessed at baseline, after interventions, and at the end of the 1-month follow-up. Treatment satisfaction was assessed with visual analog scales.

RESULTS

The defecation frequency increased and the defecation duration per attempt decreased in all groups (p < .05). In the CTM, IFC0-100 and IFC100 groups, defecation frequency increased more than in the control group (u = 23.500, u = 26.500, u = 15.500, respectively), (p < .001). The constipation severity decreased (p < .05), and this effect was maintained in all groups at the follow-up period (p > .05). QoL improved in all groups after the interventions, and was higher in the IFC0-100 [95% CI=(-15.91-(-2.09)], and IFC100 [95% CI=(-13.99-(-0.17)], (p < .05) groups than control group at follow-up, with no significant difference between control and CTM groups (p > .05). Treatment satisfaction was significantly higher in CTM [95% CI=(-1.3557-(-0.3443)], IFC0-100 [95% CI=(-1.6911-(-0.6605)], and IFC100 [95% CI=(-1.5450-(-0.5144)] groups than control group.

CONCLUSION

Additional CTM or IFCs to BET provide significant and long-lasting (at least 1 month) contributions to the bowel functions, QoL, and increase treatment satisfaction in patients with FC.