Multimodal Rehabilitation for Post-Rectal Cancer Low Anterior Resection Syndrome: A Pilot Study

Abstract

Objectives: To demonstrate the feasibility of implementing a multimodal pelvic-perineal rehabilitation protocol and to evaluate outcomes in patients with low anterior resection syndrome (LARS) following sur-gical treatment for rectal cancer.

Materials and Methods: Prospective pilot study in patients with LARS treated with pelvic-perineal kinesiology for 12 sessions, including pelvic floor exercises, biofeedback, electrostimulation, sensory training, neuromodulation, and behavioral therapy. The primary outcome mea-sured was the LARS score, followed by changes in the ICIQ-B score. Physiological parameters, adherence, and acceptance of the protocol by patients and therapists were also evaluated.

Results: Ten patients were recruited, and nine completed the protocol. All patients showed a statistically significant reduction in their LARS score (p = 0.009). Three patients completed the treatment with no LARS symptoms. Changes in the ICIQ-B score regarding bowel control and pattern also showed favorable progress as did quality of life (p = 0.0075). Muscle parameters, sensitivity, and rectal capacity showed significant improvements. The protocol was favorably accepted by all patients and therapists.

Discussion: These findings suggest that multimodal rehabilitation is feasible and may offer relevant clinical benefits, consistent with other reports in the literature. It is important to evaluate its implementation in broader clinical contexts and to validate long-term results.

Conclusion: The implemented protocol is feasible and safe, with a positive impact on LARS symptoms in the studied group.