alexa Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography
ISSN: 2157-7595

Journal of Yoga & Physical Therapy
Open Access

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Research Article

Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography

Afsaneh Nikjooy1*, Nader Maroufi1, Esmaeil Ebrahimi1, Homayoun Hadizadeh Kharazi2, Bahar Mahjoubi3 and Hamidreza Saligheh Rad4

1Department of Physical Therapy, Iran University of Medical Sciences, Iran

2Department of Radiology, Iran University of Medical Sciences, Iran

3Department of Surgery, Iran University of Medical Sciences, Iran

4Department of Medical Physics and Biomedical Engineering, Tehran University of Medical Sciences, Iran

*Corresponding Author:
Afsaneh Nikjooy
Department of Physical Therapy
Iran University of Medical Sciences, Iran
Tel: (+98)2122227124
Fax: (+98)2122220946
E-mail: [email protected]

Received Date: April 13, 2016; Accepted Date: July 05, 2016; Published Date: July 12, 2016

Citation: Nikjooy A, Maroufi N, Ebrahimi E, Kharazi HH, Mahjoubi B, et al. (2016) Accurate Differentiation of Dyssynergic Defecation Patients from Normal Subjects Based on Abnormal Anorectal Angle in MR Defecography. J Yoga Phys Ther 6:251. doi:10.4172/2157-7595.1000251

Copyright: © 2016 Nikjooy A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Abstract Objective: We aimed to study the kinematic indices of the pelvic floor, anorectal angle and the descent of perinea, and the differing movement, in dyssynergic defecation patients in comparison with healthy controls, based on MR defecography. Methods: Twenty-two individuals involved with dyssynergic defecation constipation and fourteen healthy asymptomatic subjects fell into this study. In four dynamic pelvic floor MRI indices, namely paradox (unusual change of anorectal angle), perineal descent during straining, perineal ascent, and narrowing of anorectal angle at squeeze, were measured in patients and healthy subjects. Results: Paradox Index had the highest sensitivity (95.45%) and specificity (92.86%) for detection of dyssynergic defecation, with an R2 value of near 1 (0.902). The sensitivity and specificity of other indices were not high; therefore, no significant improvement could be achieved using other indices along with Paradox Index. Negative Predictive Value (92.85%) and Positive Predictive Value (95.45%) were only high in Paradox Index. Conclusion: Paradox Index was indicated to be the best finding of MR defecography for identifying dyssynergic defecation patients from healthy controls. Hence, MR defecography could be exploited as an authentic tool to manifest the patients the paradoxical function and the relevant muscles of pelvic floor, which could enhance their imagination of the correct defecation pattern during their treatment.


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