Clinical Trial Details
— Status: Enrolling by invitation
Administrative data
| NCT number |
NCT05899062 |
| Other study ID # |
E-60116787-020-309406 |
| Secondary ID |
|
| Status |
Enrolling by invitation |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
June 1, 2023 |
| Est. completion date |
February 29, 2024 |
Study information
| Verified date |
June 2023 |
| Source |
Pamukkale University |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
It has been determined that three out of every four people in the society do not have
sufficient physical activity level, and 54% of individuals between the ages of 15-19 and over
55 are sedentary. As a result of this, the probability of encountering the problem of
constipation may increase. There are many methods in the treatment of constipation. When
examined in terms of exercise interventions, it was found that 150 minutes of
moderate-intensity exercise per week was effective in reducing the symptoms of constipation,
while aerobic exercise performed less than 140 minutes/week did not improve the symptoms of
constipation. It has been reported that individuals who received defecation training were
particularly successful in the management of constipation symptoms.
In our study, it is aimed to examine the effectiveness of exercise interventions for
constipation. In addition, to the best of our knowledge, no study has been conducted on the
effectiveness of a telerehabilitation-based education and exercise program in patients with
constipation. It is thought that the management of patients with constipation with
telerehabilitation will ease the burden on the health system, while it will save the patient
cost and time, and will facilitate the access to treatment for patients living in
geographically disadvantaged areas. In addition, it is important for patients to participate
in distance rehabilitation studies in their professional and social lives, as it is an
innovative treatment approach. It is thought that the exercises for constipation applied in
addition to the training program may be a more effective method in improving the quality of
life and colonic motility of the patients.
Description:
Constipation is the problem of insufficient defecation caused by individual factors and is
defined as less than three defecations per week according to health professionals. In chronic
constipation, decreased frequency of defecation, hard stool, feeling of incomplete excretion
of feces and straining are seen. From a biopsychosocial point of view, it negatively affects
the health-related quality of life of the individual and is a health problem seen at a high
rate in the society (Lembo and Camilleri 2003, Talley 2004). This situation is seen as a
result of aging and affects women 2-3 times more than men (Huang et al. 2017). The incidence
of constipation is seen at a rate of 22-40% in our country, in other nations is seen at a
rate varies between 2 and 34%. (Kasap and Bor 2006, Uysal et al. 2010). Its etiology is
multifactorial; It may occur as a result of metabolic disorders, drugs used, stress, perianal
dysfunctions and other reasons (Heidelbaugh et al. 2021).
While pharmacological treatment agents such as laxatives, chlorine channel activators and
osmotic agents are used in the treatment of chronic constipation, lifestyle recommendations
including diet, probiotics and physical activity are also used. In some chronic cases,
surgical methods are preferred (Leung et al. 2011). Some of the physiotherapy interventions
used in the management of constipation are: Biofeedback, tens, interference flow and exercise
(LaCross et al. 2022). It is reported that especially exercise is effective in reducing the
symptoms of constipation (Gao et al. 2019).
In a study examining the effects of exercise and patient education on constipation, it was
reported that regular walking for 20-30 minutes a day for 12 weeks could improve constipation
symptoms (Yi et al. 2014). It has been found that 150 minutes of moderate-intensity exercise
per week is effective in reducing constipation symptoms, while aerobic exercise performed
less than 140 minutes/week does not reduce symptoms of constipation (De Schryver et al.
2005). It is also reported that individuals who receive defecation training are successful in
managing their constipation symptoms (Ruitong Gao et al. 2019). Therefore, it is thought that
lifestyle education and exercise may be effective in the management of constipation symptoms.
It has been specified that three out of every four people in the society do not have
sufficient physical activity level, and especially 54% of individuals between the ages of
15-19 and over 55 are sedentary. This sedentary lifestyle and decreased physical activity may
cause constipation by negatively affecting the colonic transit time (Active Living
Association 2010, De Schryver et al. 2005). It has been reported that the exercise and
nutrition program reduces the use of laxatives while eliminating the symptoms of constipation
in patients (Ceren Orhan et al 2015). Similarly, daily moderate-intensity exercise was found
to reduce constipation symptoms by 44% in women (Dukas et al. 2033).
Lack of exercise may predispose the individual to neurological diseases or musculoskeletal
disorders. As a result, symptoms of abdominopelvic dyssynergia and constipation occur over
time. In the treatment, it is aimed to optimize the motor coordination of the abdominal and
anal muscles (Wilson 2020, Grimes 2022). Physiotherapists are effective in organizing the
muscles and directing the internal pressure with the help of exercise methods in these
dysfunctions. Thus, colonic transition is facilitated; while the rectum contracts, the anal
sphincters can relax in time (De Schryver et al 2005).
In addition, the use of exercise programs that provide vibration in the abdominal region can
cause contractions in the abdominal muscles.It is thought that this may be effective in
reducing the symptoms of constipation by inducing colonic movements (Peters HP and De Vries
2001).
Physiotherapy and rehabilitation interventions, especially exercise therapy, are recommended
in the treatment of constipation. However, individuals who live in remote or rural areas or
cannot allocate time for such treatments due to factors such as working conditions, workplace
permission problems, time and distance may find it difficult to access treatment. A possible
solution in this context is to provide remote rehabilitation services with the help of
telerehabilitation technology (Russell 2009). Telerehabilitation is the provision of remote
rehabilitation service with the help of digital technology. Through such services, education
can be provided to the patients and family members. In addition, telerehabilitation may
include patient evaluation, diagnosis, treatment and follow-up of the prognosis. Thanks to
tele-rehabilitation, patients living in geographically disadvantaged areas have the
opportunity to access rehabilitation. As a result, the burden on the health system is reduced
and time and transportation costs are saved for the patient.It may also provide additional
benefits related to rehabilitation in patients' own occupational and social environments
(Russell et al. 2011). As far as investigators know, there is no study on telerehabilitation
enforcement in the management of constipation in the literature.
