CONTROLLED RANDOMIZED TRIAL OF VISUAL BIOFEEDBACK VERSUS MUSCLE TRAINING WITHOUT A VISUAL-DISPLAY FOR INTRACTABLE CONSTIPATION

Training to contract the abdominal muscles effectively and to relax th e pelvic floor during defecation straining helps some patients with se vere constipation. Hitherto all such training has used a visible or au dible signal of sphincter muscle activity as a biofeedback method to a ssist in relaxation. A randomised controlled trial comparing the outco me of muscular training without any biofeedback device with the same t raining supplemented by an electromyographic (EMG) record visible to t he patient is reported. Significant symptomatic improvement was noted and electromyographic measurements confirmed a decrease in pelvic floo r muscle activity during defecation straining after treatment in both groups. The outcome was similar in the two treatment groups. Muscular coordination training using personal instruction and encouragement wit hout a visual display is thus a potentially successful treatment suita ble for outpatient use by paramedical personnel.