Background. Despite several treatment modalities being described for pelvic floor dyssynergia-type constipation, the clinical evaluation of interferential current therapy (IFC) has not been examined. We aimed to examine the clinical effects of IFC therapy in the treatment of children with pelvic floor dyssynergia-type constipation. Methods. Between May 2018 and July 2019, this randomized controlled study included sixty-two children (46 boys and 16 girls) with pelvic floor dyssynergia-type constipation; their ages ranged between 7 and 15 years. The children were randomly divided into either the IFC group (n = 31) who received an active IFC therapy to stimulate the pelvic floor and external anal sphincter muscles, three times per week for four successive weeks, or the control group (n = 31) who received sham IFC stimulation. Stool-incontinence frequency per week, stool type, pelvic floor excursion, and myogenic activity of external anal sphincter were evaluated at the baseline, post-treatment, and three months after treatment termination.Results. The baseline evaluation showed non-significant differences between the IFC and control groups (p>0.05). The post-treatment results showed a statistically significant difference between both groups regarding all variables, favoring the IFC group (p
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1. Tabbers MM, Benninga MA. Constipation in children: fibre and probiotics. BMJ Clin Evid 2010; 4: 303.
2. Tabbers MM, DiLorenzo C, Berger MY; European Society for Pediatric Gastroenterology, Hepatology, and Nutrition; North American Society for Pediatric Gastroenterology. Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. J Pediatr Gastroenterol Nutr 2014; 58: 258-274.
3. Benninga MA. Quality of life is impaired in children with functional defecation disorders. J Pediatr (Rio J) 2006; 82: 403-405.
4. Wexner S, Duthie G. Constipation: Etiology, Evaluation and Management (2nd ed.) London: Springer, 2006.
5. Loening-Baucke V. Chronic constipation in children. Gastroenterology 1993; 105: 1557-1564.
6. Whitehead WE, Wald A, Diamant NE, Enck P, Pemberton JH, Rao SS. Functional disorders of the anus and rectum. Gut 199; 45 Suppl 2(Suppl 2): II55- II59.
7. Rao SS, Welcher KD, Leistikow JS. Obstructive defecation: a failure of rectoanal coordination. Am J Gastroenterol 1998; 93: 1042-1050.
8. Tantawy SA, Kamel DM, Abdelbasset WK, Elgohary HM. Effects of a proposed physical activity and diet control to manage constipation in middle-aged obese women. Diabetes Metab Syndr Obes 2017; 10: 513-519.
9. Brazzelli M, Griffiths PV, Cody JD, Tappin D. Behavioural and cognitive interventions with or without other treatments for the management of faecal incontinence in children. Cochrane Database Syst Rev 2011; 2011: CD002240.
10. Koppen IJ, von Gontard A, Chase J, et al. Management of functional nonretentive fecal incontinence in children: recommendations from the International Children’s Continence Society. J Pediatr Urol 2016; 12: 56-64.
11. De Gennaro M, Capitanucci ML, Mosiello G, Zaccara A. Current state of nerve stimulation technique for lower urinary tract dysfunction in children. J Urol 2011; 185: 1571-1577.
12. Brill SA, Margolin DA. Sacral nerve stimulation for the treatment of fecal incontinence. Clin Colon Rectal Surg 2005; 18: 38-41.
13. Facci LM, Nowotny JP, Tormem F, Trevisani VF. Effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) in patients with nonspecific chronic low back pain: randomized clinical trial. Sao Paulo Med J 2011; 129: 206-216.
14. Turkan A, Inci Y, Fazli D. The short-term effects of physical therapy in different intensities of urodynamic stress incontinence. Gynecol Obstet Invest 2005; 59: 43-48.
15. Abdelhalim, NM, Ibrahim, MM. A comparative study of transcutaneous interferential electrical stimulation and transcutaneous electrical nerve stimulation on children with primary nocturnal enuresis: a randomized clinical trial. Int Urol Nephrol 2020; 52: 409-415.
16. Queralto M, Vitton V, Bouvier M, Abysique A, Portier G. Interferential therapy: a new treatment for slow transit constipation. A pilot study in adults. Colorectal Dis 2013; 15: e35-e39.
17. Clarke MC, Chase JW, Gibb S, et al. Decreased colonic transit time after transcutaneous interferential electrical stimulation in children with slow transit constipation. J Pediatr Surg 2009; 44: 408-412.
18. Ismail KA, Chase J, Gibb S, et al. Daily transabdominal electrical stimulation at home increased defecation in children with slow-transit constipation: a pilot study. J Pediatr Surg 2009; 44: 2388-2392.
19. Hull M, Corton MM. Evaluation of the levator ani and pelvic wall muscles in levator ani syndrome. Urol Nurs 2009; 29: 225-231.
20. Muddasani, S, Moe A, Semmelrock C, et al. Physical therapy for fecal incontinence in children with pelvic floor dyssynergia. J Pediatr 2017; 190: 74-78.
21. Rao SS, Seaton K, Miller M, et al. Randomized controlled trial of biofeedback, sham feedback, and standard therapy for dyssynergic defecation. Clin Gastroenterol Hepatol 2007; 5: 331-338.
22. Rao SS, Valestin J, Brown CK, Zimmerman B, Schulze K. Long-term efficacy of biofeedback therapy for dyssynergic defecation: randomized controlled trial. AmJ Gastroenterol 2010; 105: 890-896.
23. Rao SS. Endpoints for therapeutic interventions in faecal incontinence: small step or game changer. Neurogastroenterol Motil 2016; 28: 1123-1133.
24. Lewis SJ. Heaton KW, Stool form scale as a useful guide to intestinal transit time. Scand J Gastroenterol 1997; 32: 920-924.
25. Samhan AF, Abd-Elhalim NM, Elnegmy EH, Elnaggar RK and Mahoud WS. Efficacy of parasacral transcutaneous electrical nerve stimulation in treatment of children with overactive bladder. World Appl Sci J 2012; 18: 343-348.
26. Preston DM, Lennard-Jones JE. Anismus in chronic constipation. Dig Dis Sci 1985; 30: 413-418.
27. Kajbafzadeh AM, Sharifi-Rad L, Nejat F, Kajbafzadeh M, Talaei HR. Transcutaneous interferential electrical stimulation for management of neurogenic bowel dysfunction in children with myelomeningocele. Int J Colorectal Dis 2012; 27: 453-458.
28. Mauroy B, Goullet E, Bonnal JL, Devillers P, Soret R, Ametepe B. Long-term results of interferential current stimulation in the treatment of bladder instability. Prog Urol 2001; 11: 34-39.
29. Nemec H. Interferential therapy: a new therapy in physical medicine. Br J Physiother 1959; 12: 9-12.
30. Bowman BR, McNeal DR. Response of single alpha motoneurons to high-frequency pulse trains. Firing behavior and conduction block phenomenon. Appl Neurophysiol 1986; 49: 121-138.
31. Fiori A, Cescon CLC, Galesky JDF, Santos TACD, Brancalhão RMC, Bertolini GRF. Comparison between bipolar and tetrapolar of the interferential current in nociceptive threshold, accommodation and pleasantness in healthy individuals. Eur J Physiother 2014; 16: 201-205.
32. Kajbafzadeh AM, Sharifi-Rad L, Ladi-Seyedian SS, Mozafarpour S. Transcutaneous interferential electrical stimulation for the management of nonneuropathic underactive bladder in children: a randomised clinical trial. BJU Int 2016; 117: 793-800.
33. van Wunnik BFW, Baeten CGMI, Southwell BR. Neuromodulation for constipation: sacral and transcutaneous stimulation. Best Pract Res Clin Gastroenterol 2011; 25: 181-191.
34. Clarke MC, Catto-Smith AG, King SK, et al. Transabdominal electrical stimulation increases colonic propagating pressure waves in paediatric slow transit constipation. J Pediatr Surg 2012; 47: 2279-2284.
35. Kajbafzadeh AM, Sharifi-Rad L, Baradaran N, Nejat F. Effect of pelvic floor interferential electrostimulation on urodynamic parameters and incontinency of children with myelomeningocele and detrusor overactivity. Urology 2009; 74: 324-329.
36. Leong LC, Yik YI, Catto-Smith AG, Robertson VJ, Hutson JM, Southwell BR. Long-term effects of transabdominal electrical stimulation in treating children with slow-transit constipation. J Pediatr Surg 2011; 46: 2309-2312.
37. Chase J, Robertson VJ, Southwell B, Hutson J, Gibb S. Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment-resistant constipation and soiling in children. J Gastroenterol Hepatol 2005; 20: 1054- 1061