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物理治療
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Background and Purpose: Constipation is prevalent in female population (17.4%) and may be associated with pelvic floor muscle (PFM) dysfunction. Previous studies demonstrated that stronger PFMs are associated with less symptom severity of pelvic floor disorders (e.g., pelvic organ prolapse). However, little is known about the correlations between PFM function and symptoms severity in women with constipation. The purpose of this study was to investigate the correlation between severity of symptoms and PFM function in female adults with constipation. Methods: Twelve female adults with constipation were recruited from the hospital, clinics, and community from January 2021 to June 2021. The symptom severity of constipation was evaluated using the Patient Assessment of Constipation Symptoms (PAC-SYM), which includes 3 subscales (abdominal, rectal, and stool). The items are scored on a 5-point Likert scale, and the higher scores indicate the greater severity of symptoms. Pelvic floor muscle function, including resting tone, strength of maximal voluntary contraction, straining effort, and endurance of puborectalis and external anal sphincter, was assessed by the manometry and digital rectal examination scored using the International Continence Society scale (absent, weak, moderate, or strong). Spearman's correlation analysis was conducted and a coefficient of ＜ 0.10, 0.10-0.39, 0.40-0.69, 0.70-0.89, ＞ 0.90 indicated negligible, weak, moderate, strong, or very strong correlation, respectively. A significant level of correlation was taken as p ＜ 0.05. Results: Data of 11 women were included in the final analysis (one was excluded due to incomplete assessment). The score of PAC-SYM abdominal scale was moderately correlated with the maximal voluntary contraction of puborectalis (r_s = -0.653, p = 0.029) and the straining effort (r_s = -0.605, p = 0.049). Conclusion: The severity of constipation symptoms appears to have moderate correlations with the maximal voluntary contraction of PFM and the straining effort in female adults with constipation; nevertheless, studies with a larger sample size are needed to clarify the relationships between these two factors. Clinical Relevance: The results of this study may provide us with both basis for future research and the indication during clinical practice to include assessments of PFM function, with the intent to provide PFM interventions for patients with constipation to improve their symptom severity.