Investigation of the Effect of Manual Therapy and Pelvic Floor Exercises on Pelvic Floor Muscles

• Female participants aged 18-55 years with constipation complaints will be recruited through social media and hospital outpatient clinics, and those who volunteer to participate will be enrolled in the study.
• Participants will be assessed as group 1 (pelvic floor exercises), group 2 (pelvic floor exercises + manual therapy techniques). Group 1 will receive diaphragmatic breathing training and then pelvic floor exercises to strengthen the pelvic floor.
• Group 2 will receive manual therapy methods consisting of Momentum Minus Mobilisation, Sphincter Opening, Colon Massage, Global Fascial Manipulation, Trigger Point and Myofascial Release in addition to Diaphragmatic Breathing Training and Pelvic Floor Exercises.
• Participants will receive exercise training 5 days a week for 6 weeks. Manual therapy methods will be used 2 days a week for the first 2 weeks and then 1 day a week. Initial assessment of participants and manual therapy applications will be done face to face. The exercises will be continued using the online telerehabilitation method.
• Both groups will be given nutritional advice, such as drinking plenty of water, eating fibre-rich foods and preferring foods that aid digestion. Participants will be advised to take their time every day, in the morning, at the same time, without rushing to defecate, preferring an squat toilet, which increases intra-abdominal pressure, half an hour after meals, but not for more than five minutes.If a European toilet is used, toilet training will be given about leaving a 15-18 cm long ridge under the feet.
• Both groups will be given assessment tests before and at the end of the trial and the results will be compared.

Inclusion criteria

• Constipation in the last 6 months
• Being able to use smartphones and social media (whatsapp and instagram)
• Not having a health problem that prevents exercise
• Able to communicate
• Literate

Exclusion criteria

• Not had constipation in the last 6 months
• Pregnancy or recent pregnancy
• had surgery
• having a tumour
• Having vertigo Taking medication (use of bowel-regulating drugs)
• Previous physiotherapy for constipation problems
• Inflammatory bowel disease