Cystic fibrosis and pelvic floor dysfunction: A pilot study – part B

Mrs Lizelle Miller1, Dr Judith Hough1,2, Mrs  Sheridan Guyatt1

1Mater Hospital Brisbane, Brisbane, Australia, 2Australian Catholic University, Brisbane, Australia

Cystic Fibrosis (CF) is a genetic condition affecting about 3200 Australians. Coughing, which is a major feature of CF, is reported to be the major cause of urinary leakage. Part A of this study investigated the prevalence of pelvic floor dysfunction in this population.  Based on this, a pilot intervention study (part B) followed.  Interventions focussed on the pelvic floor muscles, which play an important role in continence and are usually the first line treatment option.

The pilot study was designed based on questionnaire outcome completed in part A. All applicants who indicated bother by bladder/bowel symptoms on the Australian Pelvic Floor Questionnaire (APFQ), were invited to learn about pelvic floor muscle activation and undergo 6 months of pelvic floor muscle training (PFMT). Nine participants opted to be part of the study and completed the  6 month training.  Initial assessment included the use of  real time ultrasound to identify pelvic floor muscle action and a treatment programme was based on this assessment.  The APFQ was completed at the end of 6 months and results were analysed then compared to pre-treatment questionnaires.

Statistically, there was no significant improvement post intervention for either the Bladder (p=0.672) or Bowel (p=0.096); however 7 of the 9 participants reported a decrease APFQ/improved score. Further exploration of the individual questions on bowel function revealed that although there were no significant differences when comparing pre to post physiotherapy intervention, all questions (with the exception of Q16: frequency of opening bowels) showed an improved score after physiotherapy. Of particular note, for Q24: ‘do you leak normal stool when you don’t mean to?’, 3 participants showed an improved score and no participants were worse (p=0.083).

This pilot study is showing that pelvic floor rehabilitation improved bowel continence. Numbers were small for this pilot and further research is recommended to gain further understanding into treatment protocols.

Biography: To be confirmed

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