Related Experiment Video
Updated: Jul 2, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Pediatric intensive bowel continence rehabilitation training: a retrospective study to evaluate feasibility,
Alessia Aiello1, Marta Bertamino2, Alessio Pini Prato3
1Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy - alessiaaiello@gaslini.org.
Insights
This study shows an intensive pelvic floor rehabilitation program significantly improves continence in children with Hirschsprung
Area of Science:
- Pediatric Rehabilitation
- Continence Dysfunction Management
- Pelvic Floor Therapy
Background:
- Pediatric continence dysfunction affects quality of life and can persist into adulthood.
- Children with Hirschsprung's disease and anorectal malformations are a high-risk group.
- Rehabilitation strategies for this population remain underexplored.
Purpose of the Study:
- To assess the feasibility, tolerance, and effectiveness of a technologically aided, individualized pelvic floor rehabilitation program for pediatric patients.
- To address the gap in rehabilitation research for pediatric continence dysfunction.
Main Methods:
- A single-center, retrospective observational study involving 31 children (aged 5-14) with Hirschsprung's disease or anorectal malformations.
- Customized rehabilitation programs focused on pelvic floor muscle function, rectal sensitivity, and bowel movement frequency.
- Intensive outpatient treatment (5-10 days) followed by a home training program.
Main Results:
- 29 out of 31 children (96.8%) completed the training.
- Significant global improvement in continence functioning was observed at follow-up (T1 and T3) using Rintala and Wexner scores (P<0.0001).
- No adverse effects were reported during the rehabilitation program.
Conclusions:
- The specialized pediatric pelvic floor rehabilitation program is effective and safe for children with continence issues post-surgery for Hirschsprung's disease and anorectal malformations.
- Integration of this multimodal continence rehabilitation program can prevent long-term health impairments and reduce socioeconomic burden.
- Further research into technologically aided rehabilitation is warranted.
Background:
Pediatric continence dysfunction is not uncommon. It causes long-term disability, impairing quality of life, activities and relationships with pears and can affect until adulthood. A high-risk population are children with Hirschsprung's disease and congenital anorectal malformation. Conservative medical and surgical management of continence dysfunction in this population is deeply described, while the rehabilitation issues are still unexplored. Aim of this study is to preliminary verify the feasibility, tolerance and effectiveness of an intensive technological aided and individualized pelvic floor rehabilitation program for pediatric patients.
Methods:
This is a single-center, retrospective observational study. The assessment was performed by collecting demographic data, general and local physical examination and scoring assessment tools (Rintala Continence Score and Wexner Score). The study was conducted in the Rehabilitation Unit of the pediatric Giannina Gaslini Institute, a tertiary care pediatric hospital in Genoa (Italy) between September 2015 to August 2019. We enrolled 31 children; 25 male (80.6%) and six females (19%), aged between 5 and 14 years (mean age 9 years) at the beginning of the training. Twenty children (65.5%) had Hirschsprung's disease, and 11 children (34.5%) had a congenital anorectal malformation. The rehabilitation training program was customized on the compromised function, the anatomic characteristics, the child's age and compliance. The training was aimed at improving tone, strength, endurance of the pelvic floor, compliance and rectal sensitivity, and also the frequency of the bowel movements. All patients enrolled in the study underwent an intensive outpatient treatment lasted 5 days for children older than 7 years; 10 days for younger. The intensive rehabilitation treatment was followed by a continuous home training program.
Results:
Twenty-nine children (96.8%) completed the training. A global improvement is observed in continence functioning in all the cohort at T1 (P<0.0001), maintained at T3 (P<0.0001) at both Rintala Continence Score and Wexner Score. No adverse effects have been referred.
Conclusions:
Our specific pediatric training program for pelvic floor rehabilitation is effective and safe for children with continence dysfunctions after pelvic surgery due to Hirschsprung's disease and anorectal malformations. The continence rehabilitation multimodal program should be integrated in the care of children with continence dysfunctions. It cooperates in the prevention of the long-term health global impairment and also in the reduction of social economic effort.
