scholarly journals OUTLET OBSTRUCTED CONSTIPATION AND FECAL INCONTINENCE: IS REHABILITATION TREATMENT THE WAY? MYTH OR REALITY

2020 ◽  
Vol 57 (2) ◽  
pp. 198-202
Author(s):  
Luigi BRUSCIANO ◽  
Claudio GAMBARDELLA ◽  
Gianmattia DEL GENIO ◽  
Salvatore TOLONE ◽  
Francesco Saverio LUCIDO ◽  
...  

ABSTRACT Pelvic floor rehabilitation aims to address perineal functional and anatomic alterations as well as thoraco-abdominal mechanic dysfunctions leading to procto-urologic diseases like constipation, fecal and urinary incontinence, and pelvic pain. They require a multidimensional approach, with a significant impact on patients quality of life. An exhaustive clinical and instrumental protocol to assess defecation disorders should include clinical and instrumental evaluation as well as several clinical/physiatric parameters. All these parameters must be considered in order to recognize and define any potential factor playing a role in the functional aspects of incontinence, constipation and pelvic pain. After such evaluation, having precisely identified any thoraco-abdomino-perineal anatomic and functional alterations, a pelvi-perineal rehabilitation program can be carried out to correct the abovementioned alterations and to obtain clinical improvement. The success of the rehabilitative process is linked to several factors such as a careful evaluation of the patient, aimed to select the most appropriate and specific targeted rehabilitative therapy, the therapist’s scrupulous hard work, especially as regards the patient’s emotional and psychic state, and finally the patient’s compliance in undertaking the therapy itself, especially at home. These factors may deeply influence the overall outcomes of the rehabilitative therapies, ranging from “real” success to illusion “myth”.

2018 ◽  
Vol 71 (5) ◽  
pp. 2496-2505 ◽  
Author(s):  
Maria Helena Baena de Moraes Lopes ◽  
Juliana Neves da Costa ◽  
Mariana Bezzon Bicalho ◽  
Ticiane Ellen Casale ◽  
Agnês Raquel Camisão ◽  
...  

ABSTRACT Objective: Describe the sociodemographic, clinical, and sexual profile, identify profile variables that affect the Health-Related Quality of Life (HRQoL), and evaluate the correlation between two HRQoL questionnaires used in a pelvic floor rehabilitation program. Method: This is an observational, analytical, and cross-sectional study, based on patient records and two questionnaires for HRQoL evaluation. Results: Women presented a mean age of 55.4 years; were married; white; had stress, urge, or mixed urinary incontinence (UI) of moderate to large urine release; and daily or diurnal UI. Only 50.5% had an active sex life and most had sexual complaints. The change in sexual activity and some types of UI affected the HRQoL. The two questionnaires presented a correlation. Conclusion: The profile and correlation between the questionnaires are consistent with the literature. The type of UI and changes in sexual activity affect the HRQoL.


Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 96
Author(s):  
Bruno Corrado ◽  
Benedetto Giardulli ◽  
Francesco Polito ◽  
Salvatore Aprea ◽  
Mariangela Lanzano ◽  
...  

Urinary incontinence is a hygienic and psychosocial problem that often brings people to restrict their social life and to experience depression. The main aim of this study was to evaluate the impact of urinary incontinence on quality of life among residents of the Metropolitan City of Naples, Italy, using a newly designed multidimensional questionnaire. The secondary objective was to find which variables affect the quality of life and symptom severity in these patients. To do so, a sample composed of twenty-eight patients was recruited in a multicentre cross-sectional study. Most of the participants had a mild impairment (60%) concerning social life and self-perception, especially those whose education was above the primary level (p = 0.036) and those who followed a pelvic floor rehabilitation program (p = 0.002). Overflow urinary incontinence was associated with a greater deterioration in the aspirational and occupational domain (p = 0.044). Symptom severity was worse in those who had comorbidities (p = 0.038), who had a high body mass index (p = 0.008) or who used diuretics (p = 0.007). In conclusion, our results suggest that there is a significant impairment of quality of life in patients who have only primary education and who follow a pelvic floor rehabilitation program.


2007 ◽  
Vol 177 (4S) ◽  
pp. 31-31
Author(s):  
J. Curtis Nickel ◽  
Dean Tripp ◽  
Shannon Chuai ◽  
Mark S. Litwin ◽  
Mary McNaughton-Collins

Author(s):  
М.Р. Оразов ◽  
В.Е. Радзинский ◽  
М.Б. Хамошина ◽  
Е.Н. Носенко ◽  
Э.С. Токаева ◽  
...  

Цель исследования - изучение особенностей обмена гистамина при хронической тазовой боли у пациенток с наружным генитальным эндометриозом. Методика. В сыворотке крови 100 пациенток методом высокоточного (в нг/мл) иммуноферментного твердофазного анализа определяли концентрацию гистамина. Использованы реактивы «Histamine ЕLISA», аппарат BAE-1000 Гистамин (Labor Diagnostika Nord - LDN, Германия). Оценка выраженности болевого синдрома осуществлялась по шкале ВАШ, оценка качества жизни - на основании опросника для оценки качества жизни при эндометриозе (EHR-30), оценка тревожности - опросника Спилбергера-Ханина. Результаты. Показано статистически значимое повышение уровня гистамина у пациенток с высокой интенсивностью болевого синдрома. Женщины с наружным генитальным эндометриозом, сопровождающимся интенсивным болевым синдромом в 100% случаев обнаруживали высокие уровни ситуативной и личностной тревожности, тогда как, лишь у 40% женщин (n = 16) контрольной группы выявлен умеренный уровень тревожности. Депрессивные расстройства выявлены у 58,3% женщин с хронической тазовой болью (n = 35), из них основную часть (n = 20) составили женщины с выраженной степенью болевого синдрома по ВАШ. Заключение. Психоэмоциональное состояние женщин с тазовой болью, ассоциированной с наружным генитальным эндометриозом, характеризуется высокими уровнями депрессивных и тревожных расстройств, значительным снижением уровня качества жизни. Выявлена прямая связь между интенсивностью болевого синдрома и уровнем гистамина в периферической крови пациенток с наружным генитальным эндометриозом. Objective. To study features of histamine metabolism in patients with chronic pelvic pain associated with external genital endometriosis. Methods. For quantitative assessment of histamine level in peripheral blood was taken from 100 patients which than was centrifuged. In blood serum histamine concentration was determined by enzyme-linked immunosorbent assay method with reagents «Histamine ЕLISA» on the machine BAE-1000 Histamine (Labor Diagnostika Nord - LDN, Hermany). A pain syndrome was assessed by Visual Analog Scale (VAS), quality of life assessment - by Endometriosis Health Profile Questionnaire (EHR-30), level of anxiety was determined by Spielberger-Khanin questionnaire. The results. Showed statistically higher histamine level in patients with severe pain according to VAS. After assessment of results obtained from Spielberger-Khanin questionnaire 100% experimental group’s women with external genital endometriosis (n = 60) were noted to be have high level of state and trait anxiety, then 40% women of control group (n = 16) have moderate level of anxiety. The incidence of depression in women with chronic pelvic pain was 58.3% (n = 35) and the main part (n = 20) were women with severe stage of pelvic pain according to VAS. Conclusions. Psycho emotional condition of women with external genital endometriosis associated pelvic pain characterized by higher depression and anxiety levels, with significant decrease quality of life. Direct relationship also was found between pain syndrome intensity and histamine level in peripheral blood in patients with external genital endometriosis.


2021 ◽  
pp. 1-12
Author(s):  
Sergiu Albu ◽  
Nicolas Rivas Zozaya ◽  
Narda Murillo ◽  
Alberto Garcia-Molina ◽  
Cristian Andres Figueroa Chacón ◽  
...  

BACKGROUND: Coronavirus disease 2019 (COVID-19) patients present long-lasting physical and neuropsychological impairment, which may require rehabilitation. OBJECTIVES: The current cross-sectional study characterizes post COVID-19 sequelae and persistent symptoms in patients in an outpatient rehabilitation program. METHODS: Thirty patients [16 post-ICU and 14 non-ICU; median age = 54(43.8–62) years; 19 men] presenting sequelae and/or persistent symptoms (>3 months after acute COVID-19) were selected of 41 patients referred for neurorehabilitation. Patients underwent physical, neuropsychological and respiratory evaluation and assessment of impact of fatigue and quality of life. RESULTS: The main reasons for referral to rehabilitation were: fatigue (86.6%), dyspnea (66.7%), subjective cognitive impairment (46.7%) and neurological sequelae (33.3%). Post-ICU patient presented sequelae of critical illness myopathy and polyneuropathy, stroke and encephalopathy and lower forced vital capacity compared to non-ICU patients. Cognitive impairment was found in 63.3% of patients, with a similar profile in both sub-groups. Increased physical fatigue, anxiety and depression and low quality of life were prevalent irrespective of acute COVID-19 severity. CONCLUSIONS: The variability of post COVID-19 physical and neuropsychological impairment requires a complex screening process both in ICU and non-ICU patients. The high impact of persistent symptoms on daily life activities and quality of life, regardless of acute infection severity, indicate need for rehabilitation.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Marco Monticone ◽  
Igor Portoghese ◽  
Daniele Cazzaniga ◽  
Valentina Liquori ◽  
Giuseppe Marongiu ◽  
...  

Abstract Background General physiotherapy is a common means of rehabilitation after surgery for proximal humeral fracture (PHF). Better-targeted exercises seem worthy of investigation and the aim of this study was to assess the efficacy of a rehabilitation program including task-oriented exercises in improving disability, pain, and quality of life in patients after a PHF. Methods By means of a randomized controlled trial with one-year follow-up, 70 working patients (mean age of 49 ± 11 years; 41 females), who were selected for open reduction and internal fixation with plates caused by PHF, were randomized to be included in an experimental (n = 35) or control group (n = 35). There was a permuted-block randomization plan, and a list of program codes was previously created; subsequently, an automatic assignment system was used to conceal the allocation. The first group underwent a supervised rehabilitation program of task-oriented exercises based on patients’ specific job activities, and occupational therapy. The second group underwent general physiotherapy, including supervised mobility, strengthening and stretching exercises. Both groups individually followed programs of 60-min session three times per week for 12 weeks in the outpatient setting. The Disability Arm Shoulder Hand questionnaire (DASH; scores range from 0 to 100; primary outcome), a Pain intensity Numerical Rating Scale (scores range 0 to 10; secondary outcomes), and the Short-Form Health Survey (scores range from 0 to 100; secondary outcomes) assessed the interventions. Participants were evaluated before surgery, before and after rehabilitation (primary endpoint), and at the one-year follow-up (secondary endpoint). A linear mixed model analysis for repeated measures was carried out for each outcome measure (p < 0.05). Results Time, group and time by group showed significant effects for all outcome measures in favour of the experimental group. The DASH and the DASH work achieved clinically important between-group differences of 16.0 points (95% confidence interval [C.I.] 7.3 to 24.7) and 19.7 (95% C.I. 9.0 to 30.5) at follow-up, respectively. The NRS achieved a between-group difference of 2.9 (95% C.I. 1.0 to 3.9) at follow-up. As for SF-36, there were between-group differences ranging from 17.9 to 37.0 at follow-up. Conclusions A rehabilitation program based on task-oriented exercises was useful in improving disability, pain, and quality of life in working patients after PHFs. Improvements lasted for at least 12 months. Trial registration On 16/12/2019, the trial was retrospectively registered in the ISRCTN registry with the ID number 17996552.


Author(s):  
Bernat-Carles Serdà Ferrer

The Quality of Life (QoL) is a multidimensional, dynamic and modular concept. QoL is influenced by psychological mechanisms related to the adaptation disease. The aim of this paper is to describe the research line on QoL and chronic disease. The specific objective is to determine the mechanisms involved in the change of QoL in a group of elderly people with cancer. Method. The study is prospective quasi-experimental. With a sample of 130 participants with cancer. Results. The rehabilitation program improves muscular fitness, cardiovascular efficiency, (at rest and effort) and reduces the continued decline related to treatment. We have observed a significant increase in QoL in the period evaluated. This result confirms that QoL at baseline of the disease is low. Adherence to the program achieved is 93%. Conclusions. We confirm the effectiveness of a rehabilitation program tailored to the symptoms generated by the disease and cancer treatment in improving QoL of older people. The program is a therapeutic option to preserve the QoL of the patient in the continuum of the disease. Now we are studying the timing where the implementation of the program is most effective.


2021 ◽  
pp. 1-8
Author(s):  
Alice K. Silbergleit ◽  
Lonni Schultz ◽  
Kendra Hamilton ◽  
Peter A. LeWitt ◽  
Christos Sidiropoulos

Background: Hypokinetic dysarthria and dysphagia are known features of Parkinson’s disease; however, self-perception of their handicapping effects on emotional, physical, and functional aspects of quality of life over disease duration is less understood. Objective: 1) Based upon patient self-perception, to determine the relationship of the handicapping effects of dysphagia and dysphonia with time since diagnosis in individuals with Parkinson’s disease; 2)To determine if there is a relationship between voice and swallowing handicap throughout the course of Parkinson’s disease. Method: 277 subjects completed the Dysphagia Handicap Index and the Voice Handicap Index. Subjects were divided into three groups based on disease duration: 0–4 years, 5–9 years, and 10 + years. Results: Subjects in the longer duration group identified significantly greater perceptions of voice and swallowing handicap compared to the shorter duration groups. There was a significant positive correlation between the DHI and VHI. Conclusion: Self-perception of swallowing and voice handicap in Parkinson’s disease are associated with later stages of disease and progress in a linear fashion. Self-perception of voice and swallowing handicap parallel each other throughout disease progression in Parkinson’s disease. Individuals may be able to compensate for changes in voice and swallowing early while sensory perceptual feedback is intact. Results support early targeted questioning of patient self-perception of voice and swallowing handicap as identification of one problem indicates awareness of the other, thus creating an opportunity for early treatment and maintenance of swallowing and communication quality of life for as long as possible.


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