Connective tissue manipulation and interferential currents in patients with functional constipation: A randomized...

Functional constipation (FC) is a common condition that includes difficult, irregular bowel movements, abdominal pain, and bloating.

To investigate the comparative effectiveness of connective tissue manipulation (CTM) and interferential currents (IFCs) over behavioral education and therapy (BET) on FC.

Fifty-four patients with FC were randomly assigned into four groups. The control group received only BET, the intervention groups received CTM, IFC_0-100, or IFC₁₀₀ additional to the BET, 3 days/week for 4 weeks. CTM was initially applied to the lumbosacral area; in subsequent sessions, the lower thoracic, scapular, interscapular, and cervical regions were also included, respectively. Bowel function (7-day-bowel diary), constipation severity (Constipation Severity Instrument), and QoL (Patient Assessment of Constipation Quality of Life) were assessed at baseline, after interventions, and at the end of the 1-month follow-up. Treatment satisfaction was assessed with visual analog scales.

The defecation frequency increased and the defecation duration per attempt decreased in all groups (p < .05). In the CTM, IFC_0-100 and IFC₁₀₀ groups, defecation frequency increased more than in the control group (u = 23.500, u = 26.500, u = 15.500, respectively), (p < .001). The constipation severity decreased (p < .05), and this effect was maintained in all groups at the follow-up period (p > .05). QoL improved in all groups after the interventions, and was higher in the IFC_0-100 [95% CI=(-15.91-(-2.09)], and IFC₁₀₀ [95% CI=(-13.99-(-0.17)], (p < .05) groups than control group at follow-up, with no significant difference between control and CTM groups (p > .05). Treatment satisfaction was significantly higher in CTM [95% CI=(-1.3557-(-0.3443)], IFC_0-100 [95% CI=(-1.6911-(-0.6605)], and IFC₁₀₀ [95% CI=(-1.5450-(-0.5144)] groups than control group.

Additional CTM or IFCs to BET provide significant and long-lasting (at least 1 month) contributions to the bowel functions, QoL, and increase treatment satisfaction in patients with FC.