Home-based versus office-based biofeedback therapy for constipation with dyssynergic defecation: a randomised...

Area of Science:

• Gastroenterology
• Pelvic Floor Physical Therapy

Background:

• Office-based biofeedback therapy is effective for dyssynergic defecation but limited by accessibility and cost.
• The efficacy of home-based biofeedback therapy for constipation remains largely unknown.
• This study aimed to compare home-based and office-based biofeedback therapy outcomes.

Purpose of the Study:

• To compare the clinical and subjective outcomes of home-based versus office-based biofeedback therapy for dyssynergic defecation.
• To assess the non-inferiority of home-based biofeedback therapy compared to office-based therapy.
• To evaluate the cost-effectiveness of both treatment modalities.

Main Methods:

• A randomized controlled trial involving 100 adult outpatients with functional constipation and dyssynergic defecation.
• Patients were assigned to either office-based (therapist-guided) or home-based (self-administered with a probe) biofeedback therapy.
• Primary outcomes included dyssynergic pattern, balloon expulsion time, complete spontaneous bowel movements, and patient satisfaction, assessed via intention-to-treat and per-protocol analyses.

Main Results:

• Both home-based and office-based biofeedback significantly improved primary outcomes (p<0.0001).
• Home-based therapy demonstrated non-inferiority to office-based therapy for most primary outcomes.
• Home-based biofeedback therapy was significantly less expensive than office-based treatment (median US$1081.70 vs $1942.50).

Conclusions:

• Home-based biofeedback therapy is a viable and effective alternative to office-based therapy for dyssynergic defecation.
• The similar efficacy and lower cost of home-based therapy suggest it can significantly expand treatment accessibility.
• Further research may explore long-term outcomes and wider implementation of home-based biofeedback programs.