Chapter 5 134 Two dissemination meetings were arranged before the study started at the Proctos Clinic with collaborating pelvic floor physical therapists. The meeting provided general background and developed further knowledge in the specialty of anorectal dysfunction. During the pandemic of COVID-19, three online meetings were held to mentor these meeting. Findings of the study will be disseminated in peer-reviewed journals and presented at conferences, whether they are positive, negative, or inconclusive. Discussion To our knowledge, the PAF-study is the first RCT investigating the efficacy and effectiveness of PFPT with s-EMG biofeedback in patients with CAF. In the development and implementation of this RCT, several methodological issues were considered such as the design, the duration of the treatment and choice of PFPT modalities. Our treatment protocol consists of a combination of PFPT modalities to promote clinical improvement in patients with CAF which has proven effective in the treatment of pelvic floor disorders.21,24,46 The distressing and bothersome condition of CAF has a considerable impact on QoL. PFPT already have been proven effective in QoL in patients with pelvic pain and sexual complaints.22,47 To assess the impact of several proctologic complaints on different aspects of a patient’s life, the Proctoprom was developed and evaluates disease burden and effect of treatment.41 The Proctoprom is a valid and reliable tool that is responsive to change and that meets consensus-based standards for the selection of health measurement instruments. The use of this questionnaire will give more rise to burden patients experience in this debilitating problem. This manuscript presents and discusses the rationale, design, and methodology of a randomized controlled trial investigating PFPT as a treatment option for patients with CAF. Finally, short- and long-term outcome of treatment of CAF using this regime will be described. Findings from this trial will provide a complementary treatment option and could probably become a recommendation in clinical guidelines.
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