title: The use of abdominal muscle training, breathing exercises and abdominal massage to treat paediatric chronic functional constipation.
abstract: OBJECTIVE
  The effect of muscular training, abdominal massage and diaphragmatic breathing was compared with medical treatment in a prospective randomized trial of patients with chronic functional constipation.
  
  
  METHODS
  Patients aged 4-18 years old with functional constipation according to the Rome III criteria were randomized to physiotherapy or medical treatment. In the physiotherapy group, exercises (isometric training of the abdominal muscles, diaphragmatic breathing exercises and abdominal massage) were employed during 12 40-min sessions twice a week by a trained physiotherapist, with laxatives. Patients in the medication group were only given laxatives. Primary outcome measures were frequency of defaecation and faecal incontinence. The analysis was performed by intention-to-treat.
  
  
  RESULTS
  After 6 weeks of treatment, the frequency of bowel movements was higher in the physiotherapy group [5.1 (2.1) days/week] than in the medication group [3.9 (2.0) days/week] (P = 0.01). The frequency of faecal incontinence was no different between the groups [3.6 (1.9) days/week vs 3.0 (2.1) days/week] (P = 0.31).
  
  
  CONCLUSIONS
  The combined use of isometric training of abdominal muscles, breathing exercises and abdominal massage increased defaecation frequency after 6 weeks but faecal incontinence remained unchanged. Physiotherapy may be a useful treatment for constipation.
authors: Universidade Federal de Pernambuco, Recife, Brasil.
authors: C A G
authors: CA
authors: Silva
authors: M E F A
authors: ME
authors: Motta
mesh_terms: D000009:Abdominal Muscles / Q000502:physiology*; D000293:Adolescent; D001945:Breathing Exercises; D002648:Child; D002675:Child, Preschool; D003248:Constipation / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D003672:Defecation; D005081:Exercise Therapy; D005242:Fecal Incontinence / Q000209:etiology; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D054368:Laxatives / Q000627:therapeutic use; D008297:Male; D008405:Massage
chemical_list: D054368:Laxatives