IMPLEMENTATION OF PHYSICAL THERAPY PROTOCOL FOR FUNCTIONAL CONSTIPATION

The goal of this randomized controlled trial is to investigate the effects of standard medical treatment alone and the effects of adding different physiotherapy protocols to standard medical treatment on constipation severity, abdominal circumference, and quality of life in adults with functional constipation. Researchers will compare four groups to investigate the effects of standard medical treatment alone and the effects of adding different physiotherapy protocols to standard medical treatment. The physiotherapy protocols will include Maitland Orthopedic Manual Therapy, Electrical Russian Stimulation, Osteopathic Visceral Manipulation, Passive Peristalsis Motion Techniques, and a home program including Isometric Abdominal Muscle Exercises and hot packs. Participants will be randomly assigned to one of four groups. The control group will receive standard medical treatment alone. The three intervention groups will receive standard medical treatment combined with different physiotherapy protocols. The treatment program will last six weeks. Constipation severity and quality of life will be assessed at baseline, after the first two weeks, after the second two-week period, and after the final two weeks. Abdominal circumference will be measured before the start of treatment and after completion of the intervention

Inclusion Criteria: * All patients had functional constipation. * All patients will be diagnosed and referred by physicians. * Their ages will range from 20 to 40 years old (Rahmy et al, 2021) . * Both genders will be in study (Rahmy et al, 2021). * Patients with low physical activity or sedentary life * All understand the purpose of the session Exclusion Criteria: * Pregnancy(Salari et al., 2024) * Recent abdominal surgery(Camilleri \& Brandler, 2020) * Patients with acute ischemic bowel disease(Camilleri \& Brandler, 2020) * Intestinal obstruction(Camilleri \& Brandler, 2020) * Patients with Celiac Disease (Syam et al., 2024) * Patients with Crohn's disease(Ghosh et al., 2023) * Endocrine and metabolic causes of chronic constipation(Wang \& Yao, 2021) * Neurological causes of chronic constipation(Camilleri, 2021b)