The Effects Of Cognitive-behavioral Therapy With Biofeedback On The Quality Of Life, Anxiety And Physical Symptoms In Patients With Dyssynergic Defecation | 77741
Journal of Clinical Case Reports
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Abstract: Biofeedback Therapy Group (CBT+BFT) and only Biofeedback Therapy Group(BFT) Conclusion & Significance: In chronic diseases, rumination and failure of treatment lead to worry and anxiety that decrease the quality of life. Cognitive and behavioral therapy with biofeedback therapy can reconstruct the process of thought and cognition about the disease and can decrease anxiety, which result in increased self-monitoring and self-awareness. Statement of the Problem: Dyssynergic defecation (DD) or paradoxical puborectalis contraction syndrome, is a major cause of chronic functional constipation and it is observed in half of patients with chronic constipation. Psychological distresses and impaired health-related quality of life (QOL) are strongly related with bowel dysfunction. Dysfunction of muscle activity may be a result of sexual, physical, emotional abuse or due to uncoordinated mechanisms of defecation. The purpose of this study is to evaluate the effectiveness of cognition behavior therapy with biofeedback therapy on quality of life, anxiety and physical symptoms in patients with dyssynergic defecation. Methodology & Theoretical Orientation: 45 patients, who met the inclusion criteria were randomly divided into three study groups that received biofeedback therapy with cognitive-behavior therapy, biofeedback therapy and standard-of-care therapy. These patients were assessed by the culturally-adapted version of Short Form-36 (SF-36) and Spielberger state-trait Anxiety Inventory (STAI-Y) questionnaires before and after treatment. Furthermore, a constipation scoring system (Agachan Scoring System) and digital rectal exam (DRE) were used to show the severity of the constipation and the paradoxical contraction of the pubrectalis muscle, respectively. Findings: There were significant differences in the improvement of quality of life, anxiety and physical symptoms among cognitive-behavior therapy with with dyssynergia and those with slow transit constipation Psychosom Res.
Afsaneh Nikjooy is Assistant Professor of Physical Therapy, Department of Physical Therapy, at Iran University of Medical Sciences, Tehran, Iran. She is a Member of the International Continence Society (ICS) and Iranian Continence society (IrCS). She has worked in pelvic floor Physical Therapy for more than 14 years. She has managed several courses of pelvic floor Physical Therapy for Master students in this field in Faculty of Rehabilitation, Iran University of Medical Sciences.
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