Fecal IncontinenceNCT04380571
Biofeedback Vs Electrical Stimulation in Treatment of Fecal Incontinence
A study testing Biofeedback, Electrical stimulation and Traditional treatment in people with Fecal Incontinence and Encopresis, run by Cairo University at 1 site in Egypt.
Trial summary
Fecal incontinence is one of the most psychological frustrating problems. It occurs in children due to many causes. There is a wide range of non-invasive therapeutic approaches like Kegel exercise, Biofeedback, and posterior tibial nerve stimulation. Read more about this study
- Who is it for?
- Ages 5 to 15 years
- Conditions the study is for
- Fecal Incontinence, Encopresis, Fecal Soiling
- What is being tested?
- Biofeedback, Electrical stimulation and Traditional treatment
- Type of treatment
- Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 93 participants
- Where
- 1 siteEgypt
- Study dates
- 4 Mar 2018to 28 Feb 2019
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 5 to 15 years
- All sexes
- No healthy volunteers
- Child
Who may be able to join
- FecaI incontinence
- Normal defecation frequency,
- Normal bowel habits and
- Normal stool consistency
Who cannot join
- Children who are not cooperative,
- Children with traumatic sphincter injury,
- Children with fecal impaction,
- Children with spinal diseases causing incontinence,
- Children with anorectal malformation,
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Biofeedback Versus Bilateral Transcutaneous Electrical Nerve Stimulation in the Treatment of Functional Non-retentive Fecal Incontinence
Fecal incontinence is one of the most psychological frustrating problems. It occurs in children due to many causes. There is a wide range of non-invasive therapeutic approaches like Kegel exercise, Biofeedback, and posterior tibial nerve stimulation. However, up till now, there are no established guidelines for treatment.
the objective of this study is to evaluate and compare the early effect of Biofeedback therapy versus bilateral transcutaneous posterior tibial nerve stimulation (TPNS) as non-invasive methods in the treatment of functional non-retentive fecal incontinence (FNRFI) in children.
Read the detailed description
Functional non-retentive fecal incontinence (FNRFI) requires prolonged treatment with a wide range of non-invasive therapeutic approaches like Kegel exercise, Biofeedback, and posterior tibial nerve stimulation (PTNS). However, up till now, there are no established guidelines for treatment.1 The aim of this study is to evaluate and compare the early effect of Biofeedback therapy versus bilateral transcutaneous posterior tibial nerve stimulation (TPTNS) as non-invasive methods in the treatment of (FNRFI) in children.
Methodology: The current prospective randomized controlled study included 93 children with FNRFI who were randomly divided and allocated into three groups. Group A treated by conventional methods through dietetic regulation and Kegal exercises. Group B treated by biofeedback therapy while group C received bilateral (TPTNS). Initial manometric findings including resting pressure, squeeze pressure, 1st sensation, 1st urge, and intense urge were recorded and repeated after 3 and 6 months together with incontinence score recorded in using St' Mark's (Varizey) with the primary endpoint of improvement of the incontinence score more than 50%.
- Conditions
- Fecal Incontinence, Encopresis, Fecal Soiling
- Being tested
- Biofeedback, Electrical stimulation, Traditional treatment
- Keywords
- Fecal incontinence, Biofeedback, Transcutaneous posterior tibial nerve stimulation, Childern
- Medical subject headings
- Fecal Incontinence, Encopresis
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
BiofeedbackDevice
Biofeedback therapy in addition to the conventional measures done in the control Group. It was performed in the same position used for baseline manometry. The used protocol included strength and sensory training, twice weekly for 3 months. Strength training was performed by a double-lumen rectal PVC balloon clothed catheter (MMS U-72210).
Electrical stimulationDevice
Also called Posterior tibial nerve stimulation
A positive auto adhesive electrode was applied above the medial malleolus over the S3 dermatome. A second negative electrode was applied just below the same malleolus. Both electrodes were linked to an electrical stimulation device ( EMS physio Ltd, OX129 F, England) with a low frequency current (10 Hz), and adjustable intensity.
Traditional treatmentOther
Also called Exercises
Conventional treatment through Kegal exercises and dietetic regulation where they had received bulky food including vegetables, fruits bran and cereals. Fast foods, spicy drinks and caffeine should be limited in child's diet. Local hygiene and zinc oxide application to the perianal skin were advised to prevent skin excoriation.
| Study group | Role | What they receive |
|---|---|---|
| Biofeedback | Experimental | Biofeedback therapy in addition to the conventional measures done in the control Group. It was performed in the same position used for baseline manometry. The used protocol included strength and sensory training, twice weekly for 3 months. Strength training was performed by a double-lumen rectal PVC balloon clothed catheter (MMS U-72210). Receives: Device: Biofeedback |
| Electrical Stimulation | Experimental | Bilateral (TPTNS); was applied with an electrode above the medial malleolus A second electrode) was applied just below the same malleolus. Electrical stimulation with a low-frequency current (10 Hz), and adjustable intensity. The procedure was done for 20-30 minutes, three times per week for 3 months together with the conventional maneuvers applied in the control group. Receives: Device: Electrical stimulation |
| Control group | Active comparator | were managed by conventional methods through Kegal exercises and dietetic regulation where they had received bulky food including vegetables, fruits bran and cereals. Fast foods, spicy drinks and caffeine should be limited in child's diet. Local hygiene and zinc oxide application to the perianal skin were advised to prevent skin excoriation. Receives: Other: Traditional treatment |
What is being measured
The primary outcome is the main question the study is designed to answer.
Incontinence score using St' Mark's (Vaiszey)
Questionnaire ranging from zero (indicating complete continence) to 24 (indicating total incontinence).
Measured: 3 months after intervention
incontinence score using St' Mark's (Vaiszey)
Questionnaire ranging from zero (indicating complete continence) to 24 (indicating total incontinence).
Measured: 6 months after intervention
Secondary outcomes (10)
Resting pressure (mm hg)
Pressure during relaxation of the anal sphincter
Measured: 3 months after intervention
Resting pressure (mm hg)
Pressure during relaxation of the anal sphincter
Measured: 6 months after intervention
Squeeze pressure (mm hg)
Pressure during contraction of the anal sphincter
Measured: 3 months after intervention
Squeeze pressure (mm hg)
Pressure during contraction of the anal sphincter
Measured: 6 months after intervention
First sensation (volume of the balloon by cm water)
First sensation of the stool in the rectum
Measured: 3 months after intervention
First sensation (volume of the balloon by cm water)
First sensation of the stool in the rectum
Measured: 6 months after intervention
First Urge(volume of the balloon by cm water)
The patient is trying to hold defecation and he can
Measured: 3 months after intervention
First Urge(volume of the balloon by cm water)
The patient is trying to hold defecation and he can
Measured: 6 months after intervention
Intense urge (volume of the balloon by cm water)
The Patent can no longer control the defecation
Measured: 3 months after intervention
Intense urge (volume of the balloon by cm water)
the Patent can no longer control the defecation
Measured: 6 months after intervention
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted8 May 2020
- Study start4 Mar 2018
- Primary completion27 Dec 2018
- Study completion28 Feb 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Fecal IncontinenceStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- The current prospective randomized controlled study included 93 children with FNRFI who were randomly divided and allocated into 3 groups. were managed by conventional methods through Kegal exercises and dietetic regulation where they had received bulky food including vegetables, fruits bran and cereals. Fast foods, spicy drinks and caffeine should be limited in child's diet. Local hygiene and zinc oxide application to the perianal skin were advised to prevent skin excoriation.Biofeedback group treated by biofeedback therapy in addition to traditional treatment, while the third group is the electrical stimulation group received bilateral (TPTNS) in addition to the traditional treatment. Initial manometric findings including resting pressure (mm hg), squeeze pressure (mm hg), 1st sensation (cm water), 1st urge (cm water), and intense urge (cm water) were recorded and repeated after 3 and 6 months together with incontinence score recorded in using St' Mark's (Varizey).
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 93 participants (actual)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Olfat Ibrahim Ali, Cairo University
- Investigators
- Emad M Abdelrhman, PhD, Principal investigator, Benha University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04380571
- Sponsor's protocol ID
- Fecal incontinence
- Status last verified
- May 2020
- First submitted
- 29 Apr 2020
- Last updated
- 8 May 2020
- Results posted
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: After Publication, the investigators would like to share the data with authors interested in this topic
Study at a glance
From the registry record, last updated by the sponsor on 8 May 2020. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Biofeedback Versus Bilateral Transcutaneous Electrical Nerve Stimulation in the Treatment of Functional Non-retentive Fecal Incontinence
- ClinicalTrials.gov ID
- NCT04380571
- Acronym / sponsor ID
- Fecal incontinence
- Conditions
- Fecal Incontinence, Encopresis, Fecal Soiling
- Keywords
- Fecal incontinence, Biofeedback, Transcutaneous posterior tibial nerve stimulation, Childern
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 93 participants (actual)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 4 Mar 2018 (actual)
- Primary completion
- 27 Dec 2018 (actual)
- Study completion
- 28 Feb 2019 (actual)
- First posted
- 8 May 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Fecal incontinence is one of the most psychological frustrating problems. It occurs in children due to many causes. There is a wide range of non-invasive therapeutic approaches like Kegel exercise, Biofeedback, and posterior tibial nerve stimulation. However, up till now, there are no established guidelines for treatment.
the objective of this study is to evaluate and compare the early effect of Biofeedback therapy versus bilateral transcutaneous posterior tibial nerve stimulation (TPNS) as non-invasive methods in the treatment of functional non-retentive fecal incontinence (FNRFI) in children.
Detailed description
Functional non-retentive fecal incontinence (FNRFI) requires prolonged treatment with a wide range of non-invasive therapeutic approaches like Kegel exercise, Biofeedback, and posterior tibial nerve stimulation (PTNS). However, up till now, there are no established guidelines for treatment.1 The aim of this study is to evaluate and compare the early effect of Biofeedback therapy versus bilateral transcutaneous posterior tibial nerve stimulation (TPTNS) as non-invasive methods in the treatment of (FNRFI) in children.
Methodology: The current prospective randomized controlled study included 93 children with FNRFI who were randomly divided and allocated into three groups. Group A treated by conventional methods through dietetic regulation and Kegal exercises. Group B treated by biofeedback therapy while group C received bilateral (TPTNS). Initial manometric findings including resting pressure, squeeze pressure, 1st sensation, 1st urge, and intense urge were recorded and repeated after 3 and 6 months together with incontinence score recorded in using St' Mark's (Varizey) with the primary endpoint of improvement of the incontinence score more than 50%.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 3
- Model description
- The current prospective randomized controlled study included 93 children with FNRFI who were randomly divided and allocated into 3 groups. were managed by conventional methods through Kegal exercises and dietetic regulation where they had received bulky food including vegetables, fruits bran and cereals. Fast foods, spicy drinks and caffeine should be limited in child's diet. Local hygiene and zinc oxide application to the perianal skin were advised to prevent skin excoriation.Biofeedback group treated by biofeedback therapy in addition to traditional treatment, while the third group is the electrical stimulation group received bilateral (TPTNS) in addition to the traditional treatment. Initial manometric findings including resting pressure (mm hg), squeeze pressure (mm hg), 1st sensation (cm water), 1st urge (cm water), and intense urge (cm water) were recorded and repeated after 3 and 6 months together with incontinence score recorded in using St' Mark's (Varizey).
| Arm | Type | Receives |
|---|---|---|
| Biofeedback | Experimental | Device: BiofeedbackBiofeedback therapy in addition to the conventional measures done in the control Group. It was performed in the same position used for baseline manometry. The used protocol included strength and sensory training, twice weekly for 3 months. Strength training was performed by a double-lumen rectal PVC balloon clothed catheter (MMS U-72210). |
| Electrical Stimulation | Experimental | Device: Electrical stimulationBilateral (TPTNS); was applied with an electrode above the medial malleolus A second electrode) was applied just below the same malleolus. Electrical stimulation with a low-frequency current (10 Hz), and adjustable intensity. The procedure was done for 20-30 minutes, three times per week for 3 months together with the conventional maneuvers applied in the control group. |
| Control group | Active comparator | Other: Traditional treatmentwere managed by conventional methods through Kegal exercises and dietetic regulation where they had received bulky food including vegetables, fruits bran and cereals. Fast foods, spicy drinks and caffeine should be limited in child's diet. Local hygiene and zinc oxide application to the perianal skin were advised to prevent skin excoriation. |
Who may qualify
- Ages
- 5 to 15 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child
Key inclusion criteria (4 listed)
- FecaI incontinence
- Normal defecation frequency,
- Normal bowel habits and
- Normal stool consistency
Key exclusion criteria (5 listed)
- Children who are not cooperative,
- Children with traumatic sphincter injury,
- Children with fecal impaction,
- Children with spinal diseases causing incontinence,
- Children with anorectal malformation,
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| BiofeedbackBiofeedback therapy in addition to the conventional measures done in the control Group. It was performed in the same position used for baseline manometry. The used protocol included strength and sensory training, twice weekly for 3 months. Strength training was performed by a double-lumen rectal PVC balloon clothed catheter (MMS U-72210). | Device | Biofeedback |
| Electrical stimulationAlso: Posterior tibial nerve stimulationA positive auto adhesive electrode was applied above the medial malleolus over the S3 dermatome. A second negative electrode was applied just below the same malleolus. Both electrodes were linked to an electrical stimulation device ( EMS physio Ltd, OX129 F, England) with a low frequency current (10 Hz), and adjustable intensity. | Device | Electrical Stimulation |
| Traditional treatmentAlso: ExercisesConventional treatment through Kegal exercises and dietetic regulation where they had received bulky food including vegetables, fruits bran and cereals. Fast foods, spicy drinks and caffeine should be limited in child's diet. Local hygiene and zinc oxide application to the perianal skin were advised to prevent skin excoriation. | Other | Control group |
Primary outcome
Incontinence score using St' Mark's (Vaiszey)
Time frame: 3 months after intervention
Questionnaire ranging from zero (indicating complete continence) to 24 (indicating total incontinence).
incontinence score using St' Mark's (Vaiszey)
Time frame: 6 months after intervention
Questionnaire ranging from zero (indicating complete continence) to 24 (indicating total incontinence).
10 secondary outcomes
Resting pressure (mm hg)
Time frame: 3 months after intervention
Resting pressure (mm hg)
Time frame: 6 months after intervention
Squeeze pressure (mm hg)
Time frame: 3 months after intervention
Squeeze pressure (mm hg)
Time frame: 6 months after intervention
First sensation (volume of the balloon by cm water)
Time frame: 3 months after intervention
First sensation (volume of the balloon by cm water)
Time frame: 6 months after intervention
First Urge(volume of the balloon by cm water)
Time frame: 3 months after intervention
First Urge(volume of the balloon by cm water)
Time frame: 6 months after intervention
Intense urge (volume of the balloon by cm water)
Time frame: 3 months after intervention
Intense urge (volume of the balloon by cm water)
Time frame: 6 months after intervention
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 8 May 2020.
- Individual participant dataSharing planned: Yes. After Publication, the investigators would like to share the data with authors interested in this topic
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Emad M Abdelrhman, PhD principal investigator
Benha University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Biofeedback, Electrical stimulation and Traditional treatment in people with Fecal Incontinence and Encopresis, run by Cairo University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 4 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 8 May 2020. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Incontinence score using St' Mark's (Vaiszey) (time frame: 3 months after intervention). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 8 May 2020.