Pelvic floor muscle assessment in patients who have undergone general rehabilitation following surgery for colorectal cancer: a pilot study Kuan-Yin Lin1,2,4, Linda Denehy1,5, Catherine L Granger1,4,5, Helena C Frawley2,3 1Department of Physiotherapy, The University of Melbourne, Victoria, Australia; 2Cabrini Health, Victoria, Australia; 3Physiotherapy, La Trobe University, Victoria, Australia; 4Department of Physiotherapy, Melbourne Health, Victoria, Australia; 5Institute for Breathing and Sleep, Victoria, Australia Introduction In addition to impaired general physical function, patients often experience bladder, bowel, and sexual dysfunction following colorectal cancer (CRC) surgery.1-2 Although various outcome measures exist to evaluate pelvic floor outcomes, including patient- reported outcome measures (PROMs) (severity of symptoms) and clinician reported outcome measures (muscle strength testing, anorectal pressure manometry and real-time ultrasound), there is no gold standard measure.3 Little is known about the relationships between PROMs and pelvic floor muscle (PFM) function outcome measures in a CRC population. Results Table 1 Demographic and medical data Figure 3 Mean (standard error) scores of APFQ bowel domain and ICIQ-B bowel control domain for participants in the rehabilitation group and the ‘questionnaire’ group at baseline (T1), immediately post-intervention or at 2 months follow-up (T2), and 6 months follow-up (T3). Higher score indicates worse severity/symptoms. Scores in the APFQ bowel domain and ICIQ-B bowel control domain improved in the rehabilitation group (p = 0.037 and p = 0.026) and the improvement in ICIQ-B bowel control was sustained at 6-month follow-up (Figure 3). There were no significant differences in pelvic floor symptoms between the two groups (p > 0.05). PFM outcome measures were not significantly associated with pelvic floor symptoms at any assessment time-point. Statistically significant correlations were found between PFM outcomes measured by DRE and anorectal manometry immediately post- rehabilitation program (Spearman’s rho 0.73, p < 0.05), and DRE and TPUS at 6-month follow-up (Spearman’s rho 0.73, p < 0.05). Variables   ‘Rehabilitation’ group (n=10) ‘Questionnaire’ (quasi-control) group (n=10) Total (n=10) Mean ± SD or n (%) Male (n=7) Female (n=3)  Mean ± SD or n (%) Age, year 70.0 ± 6.2 69.3 ± 5.6 71.7 ± 8.6 69.0 ± 12.8 BMI, kg/m2 26.3 ± 4.2 25.7 ± 4.4 27.8 ± 3.9 NA Colon cancer 7 (70%) 6 (86%) 1 (33.3%) Rectal cancer 3 (30%) 1 (14%) 2 (66.7%) Stage I 2 (29%) Stage II 2 (20%) Stage III 5 (50%) 4 (57%) Pre-operative chemoradiotherapy 0 (0%) Post-operative chemotherapy 3 (43%) Pre-operative chemoradiotherapy + post-operative chemotherapy 1 (1%) Colectomy 4 (40%) Anterior resection 6 (60%) Pelvic/pelvic floor surgical history 3 (43%)  3 (100%)   8 (80%) Aims To explore changes in and differences between bladder and bowel outcomes in patients following general oncology rehabilitation compared with a questionnaire only group following surgery for CRC To assess the associations between PFM function outcome measures and pelvic floor symptoms To investigate the correlation between different PFM outcome measures. Methods Design: An exploratory analysis of pelvic floor outcomes from a pre-post study of a multidisciplinary oncology rehabilitation program Participants: Ten participants who had stage I-III CRC and had undergone an eight-week multidisciplinary oncology rehabilitation program following surgery were recruited. Data of 10 gender and level of tumour (i.e. colon or rectum) matched participants in the ‘questionnaire’ group who completed postal questionnaires only at three assessment time-points from the pre-post study were used as a ‘quasi-control’ group. Procedure: Figure 1 and Figure 2 Figure 1 Pelvic floor measures in the sagittal plane Figure 2 Flow chart of the study Conclusions Patients undergoing a general rehabilitation program following surgery for CRC demonstrated improved bowel symptoms from pre- to post- rehabilitation program. Digital rectal examination seemed to be positively correlated with both anorectal pressure manometry and TPUS following oncology rehabilitation and at 6-month follow-up. Further studies with larger sample sizes and longer-term follow-up are needed confirm these findings. REFERENCES: 1) Lange MM et al. Nat Rev Urol. 2011;8(1):51-7; 2) van Duijvendijk P et al. Surgery. 2003;133(1):56-65; 3) Messelink B et al. Neurourol. Urodyn. 2005;24(4):374-80. ACKNOWLEDGEMENTS: This study was supported by grant funding (Cabrini Institute seed funding) from the Cabrini Institute, Victoria, Australia. Lin K-Y is supported by The University of Melbourne - Melbourne International Research Scholarships. The authors would like to thank the participants, participating surgeons, and the staff from the Cabrini Health and the Centre for Allied Health Research and Education at the Cabrini Institute for their contribution and assistance to the study. CONTACT DETAILS: Kuan-Yin Lin. E-mail: kuanyinl@student.unimelb.edu.au