External Anal Sphincter Fatigability

NCT ID: NCT04067453

Last Updated: 2019-11-29

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

19 participants

Study Classification

OBSERVATIONAL

Study Start Date

2019-08-01

Study Completion Date

2019-11-02

Brief Summary

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External anal sphincter is a Skeletal muscle under voluntary control. As described in previous studies, it is mainly composed of type 1 fibers. Fatigability is a concept which has been studied and described many times in skeletal limbs muscles. Two types of fatigue are described, peripheral of central fatigue. Fatigue can been physiologic but also pathologic (due to an affection of the muscle, the peripheral nervous system or the central nervous system). Many tools have been used to measure muscle fatigability (direct strength measure on isometric contraction, electromyography, echography, oxymetry...).

Besides many fatiguing methods have been developed for every each muscle depending on its histological structure.

Anal sphincter fatigability has already been described in few manometric studies with particularly 2 measures: Fatigue Rate and Fatigue Rate Index. Moreover, no fatiguing protocol has been standardized to study it.

The primary aim of this study is to define a fatiguing protocol for external anal sphincter in order to study it in further studies. Secondary aims are to assess Electromyography as a tool for measuring this fatigability and finally to assess the link between anal sphincter fatigability and symptoms reported by patients.

Patients over 18 years old, consulting for an Anorectal Manometry with a voluntary command on the external anal sphincter are included.

History and treatment, height, weight, sex, age, Fatigue impact scale, digestive symptoms with Neurologic Bowel Disorders score and Wexner scale, urinary tract symptoms with Urinary Symptom Profile (USP) score and electromyography (Root Mean Square (RMS) and Mean Power Frequency (MPF)) and manometric data (contraction peak, fatigue rate, fatigue rate index) were recorded.

The fatiguing protocol consists in 10 sustained external anal sphincter contractions with maximal voluntary contraction of 20 seconds followed by 10 seconds of resting. A training contraction is made before the fatiguing protocol. At the end of the protocol, patients undergo a classical anorectal manometry.

Primary outcome is the difference on root mean square in electromyography between the first and the last fatiguing contraction.

Secondary outcomes were mean power frequency and manometric data (i.e. Fatigue Rate index (FRI), Fatigue Rate (FR), contraction Peak)

Influence of age, sex, symptoms, pathologies, weight on fatigability will be studied in a second analysis

Detailed Description

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Conditions

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External Anal Sphincter Fatigability

Keywords

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Anal Canal External Anal Sphincter Muscle fatigue Electromyography Anorectal Manometry

Study Design

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Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

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Patients undergoing fatiguing protocol

patient consulting for anorectal manometry in order to explore anorectal disorders with a voluntary command on external anal sphincter

Fatiguing contractions

Intervention Type OTHER

10 sustained external anal sphincter contractions with maximal voluntary contraction of 20 seconds followed by 10 seconds of resting.

Interventions

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Fatiguing contractions

10 sustained external anal sphincter contractions with maximal voluntary contraction of 20 seconds followed by 10 seconds of resting.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* over 18 years old
* voluntary command on external anal sphincter contraction during physical examination
* Anorectal disorders

Exclusion Criteria

* inability to understand simple orders
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Gérard Amarenco

OTHER

Sponsor Role lead

Responsible Party

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Gérard Amarenco

Head of Neuro-Urology department, Tenon Hospital

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Gérard Amarenco

Role: PRINCIPAL_INVESTIGATOR

Study Principal Investigator Sorbonne Université, GRC 001, GREEN, AP-HP, Hôpital Tenon, Paris, France

Locations

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department of Neuro-Urology, Hôpital Tenon

Paris, , France

Site Status

Countries

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France

Other Identifiers

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GRC--01 GREEN

Identifier Type: -

Identifier Source: org_study_id