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Related Experiment Video

Updated: Aug 5, 2025

Sit-to-stand-and-walk from 120% Knee Height: A Novel Approach to Assess Dynamic Postural Control Independent of Lead-limb

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Using a footstool does not aid simulated defecation in undifferentiated constipation: A randomized trial.

Rose Qizhengyan Trieu^1,2, Gillian Prott¹, Carol Sequeira¹

¹Neurogastroenterology Unit and Department of Gastroenterology, Royal North Shore Hospital, St Leonards, New South Wales, Australia.

Neurogastroenterology and Motility

|March 29, 2023

Summary

Using a footstool changes posture during defecation but does not improve simulated bowel movements for constipation patients. Its general recommendation for evacuation is not universally applicable.

Keywords:

anorectal manometry balloon expulsion test constipation defecation footstool

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Area of Science:

Gastroenterology
Physiology
Biomechanics

Background:

Footstools are commonly recommended to improve toilet posture and facilitate bowel evacuation.
The effectiveness of footstools in improving defecation outcomes for patients with constipation remains debated.

Purpose of the Study:

To evaluate the impact of footstool use on defecatory posture.
To assess changes in simulated defecation using a footstool in patients experiencing constipation.

Main Methods:

Forty-one patients with constipation underwent anorectal manometry and rectal balloon expulsion tests.
Tests were performed with no footstool, a 7-inch, and a 9-inch footstool.
Measurements included spinal-femoral angle and subjective ease of evacuation.

Main Results:

Footstool use significantly altered defecatory posture, narrowing the spinal-femoral angle (p < 0.001).
No significant improvement in balloon expulsion time was observed with footstool use.
Subjective assessments of evacuation ease, urge, and discomfort did not differ significantly.

Conclusions:

While footstools alter posture, they do not enhance objective or subjective measures of simulated defecation in constipation patients.
The recommendation for footstool use in all patients with constipation may not be appropriate.