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Comparative Efficacy of Transcutaneous Functional Electrical Stimulation With or Without Biofeedback Therapy on
Seyedeh-Sanam Ladi-Seyedian1,2, Lida Sharifi-Rad3,4,5, Hosein Alimadadi1,6
1Pediatric Gastroenterology and Hepatology Research Center, Pediatric Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, No. 62, Dr. Qarib St, Keshavarz Blvd, 14194 33151, Tehran, Iran.
Insights
Adding biofeedback therapy to transcutaneous functional electrical stimulation (TFES) improved fecal incontinence (FI) in children. Both TFES alone and TFES with biofeedback showed significant symptom reduction and improved quality of life.
Area of Science:
- Pediatric Gastroenterology
- Urology
- Rehabilitation Medicine
Background:
- Functional non-retentive fecal incontinence (FNRFI) affects children's quality of life.
- Conventional treatments may not be effective for all FNRFI cases.
Purpose of the Study:
- To compare the efficacy of transcutaneous functional electrical stimulation (TFES) combined with biofeedback therapy versus TFES alone in treating pediatric FNRFI.
- To evaluate the impact of these treatments on fecal incontinence scores, pain, bowel habits, and quality of life.
Main Methods:
- A prospective, single-center randomized clinical trial involving 40 children with FNRFI.
- Patients were randomized into two groups: TFES + biofeedback (Group A) and TFES alone (Group B).
- Assessments included pediatric fecal incontinence scores, pain scores, bowel habit diaries, and quality-of-life questionnaires before, during, and after treatment (6-month follow-up).
Main Results:
- Fecal incontinence significantly improved in 65% of patients receiving TFES + biofeedback and 55% receiving TFES alone.
- Both groups showed significant reductions in fecal incontinence scores, maintained at 6 months.
- Significant improvements in quality of life were observed in both groups at 6 months, with no significant difference between them.
Conclusions:
- Transcutaneous functional electrical stimulation (TFES) combined with biofeedback therapy is an effective treatment for pediatric functional non-retentive fecal incontinence.
- TFES alone also demonstrates significant benefits for FNRFI symptoms and quality of life.
- Combining electrical stimulation with other therapies can improve outcomes for FNRFI patients refractory to conventional treatments.
Background:
We compared the effects of transcutaneous functional electrical stimulation (TFES) and biofeedback therapy with TFES alone in a cohort of children with functional non-retentive fecal incontinence (FNRFI).
Methods:
This prospective, single-center randomized clinical trial was performed on 40 children with FNRFI. Patients were randomly allocated into two equal treatment groups. Group A (n = 20) underwent TFES + biofeedback therapy, and group B (n = 20) received TFES alone. All patients were assessed with a pediatric fecal incontinence (FI) score questionnaire, a visual pain score, and a bowel habit diary both before and at the end of treatment sessions and also at 6 months of follow-up. In addition, a FI quality-of-life (QoL) questionnaire was recorded for all patients before and 6 months after the treatment.
Results:
FI significantly improved in 13/20 (65%) patients in group A and 11/20 (55%) patients in group B (P < 0.05). A significant reduction in FI score was seen in each group at the end of treatment sessions and maintained at 6 months of follow-up (P < 0.05). A significant improvement in FI-QoL scores was seen in both groups at 6 months of follow-up in which there was no significant difference in terms of FI-QoL scores improvement between both groups after treatment.
Conclusions:
The use of electrical stimulation in combination with other treatment methods improves symptoms in patients with FNRFI who are refractory to conventional treatment.
