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Effect of a pelvic floor muscle training program in patients who have undergone surgery for bowel cancer

ABSTRACT: Interventions: The intervention is general rehabilitation plus pelvic floor muscle training program. The general rehabilitation will consist of a multidisciplinary education and exercise program, which will be provided as group sessions twice weekly for 8 weeks . Each session will last approximately one hour. The education component will include advice about nutrition, exercise, fatigue management and coping with stress and will be provided in a group format. Information will be delivered by a range of clinicians (physiotherapists, occupational therapists, psychologists, and dieticians). The exercise component will include an exercise training program supervised by a physiotherapist. The pelvic floor muscle training program will consist of physiotherapy-supervised pelvic floor muscle training sessions and bladder and bowel function advice over 12 sessions, twice weekly for 6 weeks. The training program will use a combination of 7 individual and 5 group sessions. Biofeedback will be used to facilitate pelvic floor muscle function. The training sessions will be approximately one hour long. The duration of intervention is eight weeks. To encourage adherence to the intervention protocols, telephone calls from a physiotherapist and a self report diary to record training adherence will be provided. Primary outcome(s): Pelvic floor symptoms as assessed using the Australian Pelvic Floor Questionnaire and the International Consultation on Incontinence Questionnaire Bowel module[at baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline] Study Design: Purpose: Treatment; Allocation: Randomised controlled trial; Masking: Blinded (masking used);Assignment: Parallel

DISEASE(S): Bowel Cancer,Physical Medicine / Rehabilitation-other Physical Medicine / Rehabilitation,Cancer-bowel-back Passage (rectum) Or Large Bowel (colon),Pelvic Floor Symptoms

PROVIDER: 2460284 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Interventions: Name: Pelvic floor rehabilitation program Rationale: Patients after anterior resection +/- radiochemotherapy for colorectal cancer can suffer from bowel dysfunction that includes faecal incontinence and defaecatory problems. A structured pelvic floor rehabilitation program on pelvic floor muscle strengthening, anorectal sensory and coordination training can improve bowel function after surgery. This study will also examine the feasibility of the intervention in an outpatient setting. Intervention: A 15 minutes of education session will be provided at the commencement of the program at first week. Participants will be provided education on normal bowel function and the bowel issues associated with colorectal cancer surgery. They will also receive information on good bladder and bowel habits, dietary advice, and pelvic floor exercises.The educational information and home exercise pamphlet is specifically designed for this study. Each participant will be assessed on their anorectal physiology by a colorectal surgeon and pelvic floor physiotherapist. Patient reported outcomes on bladder, bowel, sexual function and quality of life will be examined with questionnaires before and after the intervention. The intervention is a 10 week face to face program of weekly attendance to the outpatient clinic for 1 hour under supervision (ie 1 hour session, once per week for 10 weeks in an outpatient clinic). The program includes: pelvic floor muscle strengthening with use of transperineal ultrasound for visual biofeedback, anorectal sensory and coordination retraining using rectal balloon catheter biofeedback. Visual feedback will be provided via the application of a transperineal ultrasound. The patient will be able to visualise the pelvic floor muscle activity on the screen du Primary outcome(s): Adherence to pelvic floor rehabilitation program.Proportion with >80% attendance of supervised sessions. >80% of completion for weekly home exercises. This will be assessed by an attendance log and home exercise diary completion. [Post intervention program (12 weeks)] Study Design: Purpose: Treatment; Allocation: Non-randomised trial; Masking: Open (masking not used);Assignment: Single group;Type of endpoint: Efficacy

Project description:Context: Exercise training is a plausible model for identification of molecular mechanisms that cause metabolic-related changes in human skeletal muscle. Objective: The goal was to explore the molecular basis of the adaptation of skeletal muscle to exercise training. Design and Intervention: Obese male subjects were subjected to an individualized supervised training program targeted in order to optimize lipid oxidation during 8 weeks. Main Outcome Measures: Primary outcome measures were gene expression profiling of skeletal muscle. Body composition, oral glucose tolerance test, Resting metabolic rate, respiratory quotient, maximal oxygen uptake and metabolic biochemistry were also assessed. Overall Design The obese (BMI 30-36) male volunteers (age 32-42) were asked to refrain from vigorous physical activity 48h before presenting to the clinical investigation centre, and ate a weight-maintaining diet consisting of 35% fat, 16% protein, and 49% carbohydrates two days before the experiment. Muscle biopsies of Vastus Lateralis weighing 60–100 mg were obtained using the Bergstrom technique, cleaned and snap-frozen in liquid nitrogen. Resting metabolic rate, respiratory quotient and maximal oxygen uptake were assessed. The subjects were investigated at baseline and after 8 weeks of supervised aerobic exercise training program consisting of daily sessions of 45-60 min of endurance exercise, 5 days a week, at least 48-72h after the last acute exercise bout. Skeletal muscle biopsies were obtained at the beginning and at the end of the protocol. Transcriptome analysis compared 8 subjects before vs. after training using arrays using a common reference design (Cy5 dye was incorporated into all muscle RNA samples, while a reference RNA pool made of the mix of commercial human liver, adipose tissue and skeletal muscle RNA was labelled with Cy3 dye (Applied Biosystems/Ambion, Foster City, USA)( and whole genome 4x44k oligonucleotide arrays (Agilent Technologies).

Project description:Interventions: The general rehabilitation program will consist of a multidisciplinary education and exercise program, which will be provided as group sessions twice weekly for 8 weeks. The education component will include 1-hour nutritional advice and management provided by a dietitian; 1-hour exercise education regarding the importance of exercise to well-being, bladder and bowel advice, and adherence to exercise provided by a physiotherapist; 1-hour fatigue management and return to work strategies provided by an occupational therapist; and 5-hours health behavior change and self-management strategies provided by a psychologist. The exercise component will consist of a moderate intensity (Borg Rating of Perceived Exertion (RPE) Scale 12-14), physiotherapist-supervised, combined aerobic and resistance training program. The exercise program will be individualized based on the results from baseline outcome measures. Participants will be required to attend an one hour education session per week and an one hour exercise session per week over the 8-week intervention period. The home-based walking program requires participants to perform daily walking with duration and intensity individually prescribed based on the results of baseline walking tests. To encourage adherence to the home-based walking program, 6 telephone motivational coaching sessions (1 to 2 calls per month) will be provided from a physiotherapist, between data collection time-points 2 (immediately post-intervention) and 3 (6 months following baseline) . Daily feedback for participants regarding distance and number of steps taken will be encouraged with a simple pedometer. Primary outcome(s): Functional capacity as assessed using the six-minute walk test [At baseline, immediately post-intervention, and at 6 months following baseline];Feasibility as assessed by the recruitment rate, adherence, withdrawals, and adverse events. There are minimal risks associated with the rehabilitation and measurement tests. Participants may feel some general muscle discomfort after exercise, which is a normal response to exercise.[At baseline, immediately post-intervention, and at 6, 12, 24, and 60 months following baseline] Study Design: Purpose: Educational / counselling / training; Allocation: Non-randomised trial

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Effect of a pelvic floor muscle training program in patients who have undergone surgery for bowel cancer

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