PARiS
Research type
Research Study
Full title
Pelvic Floor Physiotherapy and Anterior Resection Syndrome
IRAS ID
191982
Contact name
Julie Cornish
Contact email
Sponsor organisation
Cwm Taf University Health Board Research & Development Department
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Summary of Research
The aim of this study is to test the feasibility of a simple intervention to improve bowel function following surgery for rectal cancer. Up to 75% of patients experience difficulty controlling their bowels for up to 12 months following surgery for rectal cancer and 1 in 4 will continue to do so for more than a year. We propose the introduction of an education session from specialist nurses and physiotherapists prior to surgery to teach patients how to improve their bowel function using a pelvic floor programme. We will assess muscle tone in the pelvis before and after surgery to see if the introduction of pelvic floor training is acceptable to patients and if they are able to comply with the programme at may be a stressful time for themselves and their family. We will recruit all patients undergoing Anterior Resection (rectal cancer surgery) in the Cardiff and Vale and Cwm Taf University Health Board, over a 12 month period. In addition to evaluating the programme we will interview patients to assess their satisfaction with the elements of the programme.Summary of Results
The aim of this study was to assess the feasibility of providing an educational and pelvic floor rehabilitation programme to improve bowel function after rectal cancer surgery.
The proposed treatment package included a preoperative educational session with a specialist pelvic floor nurse and physiotherapist covering pelvic floor anatomy and bowel function. This would be complemented by a pelvic floor rehabilitation programme (physiotherapy) to be completed independently by participants before and after their surgery.
9 of the 25 patients identified for the study agreed to take part, with common themes for declining including the psychological, time, and travel burden of additional appointments. Only 1 of the 9 participants completed the treatment programme. All other participants dropped out or were withdrawn, from the study due to complications or delays with surgery. The 1 participant that did complete the treatment programme did not report any change in bowel function as a result of their surgery.
This study highlights that, while patients are interested in physiotherapy for pelvic floor rehabilitation, there are a number of challenges that need to be considered and overcome to make it feasible. The availability of support from specialist pelvic floor physiotherapists was a significant barrier to completing the rehabilitation programme. Feedback from patients also shows that the timing of the approach is extremely important as many felt overwhelmed by the idea of receiving interventions in addition to their cancer treatment.REC name
Wales REC 6
REC reference
16/WA/0124
Date of REC Opinion
21 Apr 2016
REC opinion
Favourable Opinion