Psychomotor approach in children affected by nonretentive fecal soiling (FNRFS): a new rehabilitative purpose
Moderate EvidenceIn Plain Language
According to the Rome III criteria, encopresis without constipation was defined as nonretentive fecal soiling (FNRFS) with not yet well understood etiology. Treatment approaches reported in the literature with varying results include biofeedback, hypnosis, reflexology, and Internet-based educational programs. In developmental age, another behavioral treatment could be identified in the psychomotor approach, which is called psychomotricity in the European countries, or is also known as play therapy. The aim of the present study was to verify the safety and efficacy of play therapy plus toilet training in a small sample of prepubertal children affected by FNRFS. Twenty-six patients (group 1; 16 males, mean age of 5.92 ± 0.84 years) underwent a psychomotor approach therapy program in association with toilet training for 6 months, and the other 26 subjects (group 2; 17 males, mean age of 5.76 ± 0.69) underwent the sole toilet training program for 6 months. During the observational time period (T0) and after 6 months (T1) of both treatments, the patients were evaluated for FNRFS frequency and for the behavioral assessment. At T0, the FNRFS mean frequency per month for group 1 was 20.115 episodes/month (standard deviation [SD] ± 3.024) and for group 2 was 20.423 (SD ± 1.879) (P = 0.661). At T1 the mean frequency per month was 6.461 (SD ± 1.333) episodes/month and 12.038 (SD ± 1.341), respectively (P < 0.001). Moreover, the delta percent average of the frequency between T0 and T1 was 67.121 ± 8.527 for group 1 and 40.518 ± 9.259 for group 2 (P < 0.001). At T1, a significant improvement in scores on the behavioral scale was identified. Our preliminary results show the importance of a multidisciplinary approach, and suggest the positive effect of an additional psychomotor approach, as this holds a new and interesting rehabilitative purpose for children in a toilet training program, even if further research is necessary.
Key Findings: what this randomised trial found
- ✓Nonretentive fecal soiling (FNRFS) in children is a condition without fully understood etiology that has been treated with various approaches including biofeedback, hypnosis, reflexology, and educational programs.
- ✓Play therapy combined with toilet training was evaluated as a potential psychomotor intervention for prepubertal children with FNRFS over a 6-month treatment period.
- ✓The study compared outcomes between 26 children receiving psychomotor approach therapy plus toilet training and 26 children receiving toilet training alone to assess safety and efficacy.
What This Means for You
While this study mentions reflexology as one possible treatment, it actually tests play therapy combined with toilet training—not reflexology itself—so it doesn't directly support reflexology for this condition.
What This Means for Practitioners
This study does not evaluate reflexology outcomes; it compares psychomotor/play therapy plus toilet training to toilet training alone, so reflexologists should not cite this as evidence for treating nonretentive fecal soiling.
Study Design: how this randomised trial was run
Common questions about this study
What does this study mean in practice?
While this study mentions reflexology as one possible treatment, it actually tests play therapy combined with toilet training—not reflexology itself—so it doesn't directly support reflexology for this condition.
What did this study find?
Nonretentive fecal soiling (FNRFS) in children is a condition without fully understood etiology that has been treated with various approaches including biofeedback, hypnosis, reflexology, and educational programs. Play therapy combined with toilet training was evaluated as a potential psychomotor intervention for prepubertal children with FNRFS over a 6-month treatment period. The study compared outcomes between 26 children receiving psychomotor approach therapy plus toilet training and 26 children receiving toilet training alone to assess safety and efficacy.
How strong is this evidence?
This is a randomised trial and we rate its evidence moderate. It covers 52 participants. It was published in Neuropsychiatric disease and treatment. This study is indexed here for context; it did not test reflexology itself.
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