Research and Scholarship

The Effect of Pelvic Floor Rehabilitation on Low Anterior Resection Syndrome After Colorectal Cancer Treatment

Shelby Jones,(1,2) DNP, CCRN, Alison Edie,(2) DNP, Emily Troop,(1) DPT, Joshua S. Hill,(1) MD, and Julie A. Thompson,(2) PhD

From (1)Atrium Health Levine Cancer Institute, Charlotte, North Carolina; (2)Duke University School of Nursing, Durham, North Carolina

Authors’ disclosures of conflicts of interest are found at the end of this article.

Correspondence to: Shelby Jones DNP, CCRN, 1021 Morehead Medical Drive, Charlotte, NC 28204 E-mail: shelby.agacnp@gmail.com

Purpose: Low anterior resection (LAR) is the preferred surgical treatment of rectosigmoid or rectal cancers. However, it is often associated with bowel dysfunction, which is termed low anterior resection syndrome (LARS). Daily bowel dysfunction symptoms have a detrimental effect on quality of life (QOL). Pelvic floor rehabilitation (PFR) can improve pelvic floor function and QOL among patients with LARS. This quality improvement (QI) project seeks to assess the prevalence of LARS and develop and incorporate PFR for the treatment and prevention of LARS. Methods: A convenience sample of 20 patients met project inclusion. Thirteen patients participated. Individuals were categorized by diagnostic risk: low risk, high risk, and established. The intervention included 1-hour PFR sessions with the physical therapist (PT) and 5 minutes of daily self-led pelvic floor muscle exercises. Outcomes questionnaires included the LARS Score and Fecal Incontinence Quality of Life (FIQOL) Scale. Data were collected both pre- and post–colorectal cancer treatment. Results: The overall prevalence of LARS was 76.9%, which was significantly higher than the retrospective cohort comparison rate of 21.8% (p < .001). The prevalence of major LARS was 89%, 83%, and 50% at the initial, second, and third sessions, respectively, representing a 44% relative decrease. Embarrassment was significantly affected among individuals with major LARS, although ongoing PFR facilitated improvement. Conclusion: PFR is a valuable adjunct therapy for LARS, with continued sessions decreasing the overall prevalence among the cohort. Major LARS negatively impacts QOL measures early on in treatment but improves with continued PFR.

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