{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:41:27Z","timestamp":1792636887741,"version":"4.5.0"},"reference-count":41,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":38,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"DOI":"10.1186\/s12905-025-04186-0","type":"journal-article","created":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T09:54:30Z","timestamp":1764928470000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pelvic floor distress inventory 20 and Wexner constipation scoring system responsiveness and minimal clinical importance difference in Persian women with functional constipation"],"prefix":"10.1186","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9595-2973","authenticated-orcid":false,"given":"Fahimeh","family":"Karshenas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanaz","family":"Shanbehzadeh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanaz","family":"Ahadi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0780-2933","authenticated-orcid":false,"given":"Seyedeh Saeideh","family":"Babazadeh-Zavieh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,5]]},"reference":[{"issue":"1","key":"4186_CR1","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1053\/j.gastro.2012.10.028","volume":"144","author":"AE Bharucha","year":"2013","unstructured":"Bharucha AE, Pemberton JH, Locke GR 3. American gastroenterological association technical review on constipation. Gastroenterology. 2013;144(1):218\u201338.","journal-title":"Gastroenterology"},{"issue":"11","key":"4186_CR2","doi-asserted-by":"publisher","first-page":"2340","DOI":"10.1016\/j.mayocp.2019.01.031","volume":"94","author":"AE Bharucha","year":"2019","unstructured":"Bharucha AE, Wald A. Chronic constipation. Mayo Clin Proc. 2019;94(11):2340\u201357.","journal-title":"Mayo Clin Proc"},{"issue":"1","key":"4186_CR3","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1016\/j.cger.2013.10.001","volume":"30","author":"VC Costilla","year":"2014","unstructured":"Costilla VC, Foxx-Orenstein AE. Constipation: understanding mechanisms and management. Clin Geriatr Med. 2014;30(1):107\u201315.","journal-title":"Clin Geriatr Med"},{"issue":"1","key":"4186_CR4","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1053\/j.gastro.2003.10.044","volume":"126","author":"M Minguez","year":"2004","unstructured":"Minguez M, Herreros B, Sanchiz V, Hernandez V, Almela P, A\u00f1on R, et al. Predictive value of the balloon expulsion test for excluding the diagnosis of pelvic floor dyssynergia in constipation. Gastroenterology. 2004;126(1):57\u201362.","journal-title":"Gastroenterology"},{"issue":"10","key":"4186_CR5","doi-asserted-by":"publisher","first-page":"3588","DOI":"10.1007\/s10620-020-06654-z","volume":"66","author":"M Bouchoucha","year":"2021","unstructured":"Bouchoucha M, Fysekidis M, Deutsch D, Bejou B, Sabate J-M, Benamouzig R. Biopsychosocial model and perceived constipation severity according to the constipation phenotype. Dig Dis Sci. 2021;66(10):3588\u201396.","journal-title":"Dig Dis Sci"},{"key":"4186_CR6","doi-asserted-by":"crossref","unstructured":"Johnston BC, Ebrahim S, Carrasco-Labra A, Furukawa TA, Patrick DL, Crawford MW et al. Minim Important Difference Estimates Methods: Protoc. 2015;5(10):1-10.","DOI":"10.1136\/bmjopen-2015-007953"},{"issue":"1","key":"4186_CR7","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.jclinepi.2006.03.012","volume":"60","author":"CB Terwee","year":"2007","unstructured":"Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34\u201342.","journal-title":"J Clin Epidemiol"},{"key":"4186_CR8","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00192-006-0252-1","volume":"18","author":"MD Barber","year":"2007","unstructured":"Barber MD. Questionnaires for women with pelvic floor disorders. Int Urogynecol J. 2007;18:461\u20135.","journal-title":"Int Urogynecol J"},{"issue":"3","key":"4186_CR9","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1179\/2042618612Y.0000000001","volume":"20","author":"A Wright","year":"2012","unstructured":"Wright A, Hannon J, Hegedus EJ, Kavchak AE. Clinimetrics corner: a closer look at the minimal clinically important difference (MCID). J Man Manip Ther. 2012;20(3):160\u20136.","journal-title":"J Man Manip Ther"},{"issue":"12","key":"4186_CR10","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.1111\/apt.16369","volume":"53","author":"A Sharma","year":"2021","unstructured":"Sharma A, Rao SSC, Kearns K, Orleck KD, Waldman SA. Review article: diagnosis, management and patient perspectives of the spectrum of constipation disorders. Aliment Pharmacol Ther. 2021;53(12):1250\u201367.","journal-title":"Aliment Pharmacol Ther"},{"issue":"1","key":"4186_CR11","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1016\/j.ajog.2004.12.025","volume":"193","author":"M Barber","year":"2005","unstructured":"Barber M, Walters M, Bump R. Short forms of two condition-specific quality-of-life questionnaires for women with pelvic floor disorders (PFDI-20 and PFIQ-7). Am J Obstet Gynecol. 2005;193(1):103\u201313.","journal-title":"Am J Obstet Gynecol"},{"issue":"4","key":"4186_CR12","doi-asserted-by":"publisher","first-page":"E82","DOI":"10.1179\/jmt.2008.16.4.82E","volume":"16","author":"CE Cook","year":"2008","unstructured":"Cook CE. Clinimetrics corner: the minimal clinically important change score (MCID): a necessary pretense. J Man Manip Ther. 2008;16(4):E82-3.","journal-title":"J Man Manip Ther"},{"issue":"4","key":"4186_CR13","first-page":"689","volume":"4","author":"JA Bernstein","year":"2016","unstructured":"Bernstein JA, Mauger DT. The minimally clinically important difference (MCID): what difference does it make? The Journal of Allergy and Clinical Immunology: In Practice. 2016;4(4):689\u201390.","journal-title":"The Journal of Allergy and Clinical Immunology: In Practice"},{"issue":"4","key":"4186_CR14","doi-asserted-by":"publisher","first-page":"551","DOI":"10.1177\/0194599819852604","volume":"161","author":"AR Sedaghat","year":"2019","unstructured":"Sedaghat AR. <article-title update=\"added\">Understanding the minimal clinically important difference (MCID) of patient\u2010reported outcome measures. Otolaryngol Head Neck Surg. 2019;161(4):551\u201360.","journal-title":"Otolaryngol Head Neck Surg"},{"key":"4186_CR15","doi-asserted-by":"crossref","unstructured":"Hakimi S, Hajebrahimi S, Bastani P, Aminian E, Ghana S. Mohammadi MJBo. 208: translation and validation of the pelvic floor distress inventory short form (PFDI-20), Iranian version. BMJ Open. 2017;7(Suppl 1):bmjopen-2016-015415.208.","DOI":"10.1136\/bmjopen-2016-015415.208"},{"issue":"3","key":"4186_CR16","first-page":"243","volume":"14","author":"F Majidirad","year":"2021","unstructured":"Majidirad F, Hadian MR, Asl Soleimani H, Jalaie S, Ahadi T, Bazaz Bebahani R, et al. Cross-cultural adaptation, validity, and reliability of the Wexner questionnaire in patients with functional constipation in an Iranian population. Gastroenterol Hepatol Bed Bench. 2021;14(3):243\u20139.","journal-title":"Gastroenterol Hepatol Bed Bench"},{"key":"4186_CR17","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1007\/BF02056950","volume":"39","author":"F Agachan","year":"1996","unstructured":"Agachan F, Chen T, Pfeifer J, Reissman P, Wexner SD. A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum. 1996;39:681\u20135.","journal-title":"Dis Colon Rectum"},{"issue":"1","key":"4186_CR18","doi-asserted-by":"publisher","first-page":"17","DOI":"10.32598\/fdj.3.128.2","volume":"3","author":"P Mirbehresi","year":"2020","unstructured":"Mirbehresi P, Nikjooy A, Sarrafzadeh J, Mohsenifar H. Cultural Adaptation, Validity, and reliability of the Persian version of Wexner constipation scoring system %J. Function Disabil J. 2020;3(1):17\u201326.","journal-title":"Function Disabil J"},{"key":"4186_CR19","unstructured":"Mirshahvelayati AS, Manshadi FDJTSJRM. Relationship between clinical symptoms and manometric findings in women with functional constipation. Sci J Rehabil Med. 2015;4(3):94\u2013100."},{"issue":"4","key":"4186_CR20","first-page":"445","volume":"16","author":"Z Abbas Ebadi","year":"2017","unstructured":"Abbas Ebadi Z, Taghizadeh A, Montazeri Z, Shahvari M, Tavousi. Razieh Bagherzadeh. Translation, development and psychometric properties of health related measures-Part 2: construct validity, reliability and responsiveness %J Payesh (Health Monitor). Journal. 2017;16(4):445\u201355.","journal-title":"Journal"},{"issue":"4","key":"4186_CR21","first-page":"410","volume":"63","author":"S Lawson","year":"2018","unstructured":"Lawson S. Sacks AJJom, health Ws. Pelvic Floor Phys Therapy Women\u2019s Health Promotion. 2018;63(4):410\u20137.","journal-title":"Pelvic Floor Phys Therapy Women\u2019s Health Promotion"},{"key":"4186_CR22","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1016\/j.ejogrb.2020.10.039","volume":"255","author":"VB de Figueiredo","year":"2020","unstructured":"de Figueiredo VB, Ferreira CHJ, da Silva JB, de Oliveira Esmeraldo GND, Brito LGO, do Nascimento SL, et al. Responsiveness of Pelvic Floor Distress Inventory (PFDI-20) and Pelvic Floor Impact Questionnaire (PFIQ-7) after pelvic floor muscle training in women with stress and mixed urinary incontinence. Eur J Obstet Gynecol Reprod Biol. 2020;255:129\u201333.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"3","key":"4186_CR23","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1179\/jmt.2009.17.3.163","volume":"17","author":"SJ Kamper","year":"2009","unstructured":"Kamper SJ, Maher CG, Mackay G. Global rating of change scales: a review of strengths and weaknesses and considerations for design. J Man Manip Ther. 2009;17(3):163\u201370.","journal-title":"J Man Manip Ther"},{"issue":"10","key":"4186_CR24","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1093\/ptj\/76.10.1109","volume":"76","author":"PW Stratford","year":"1996","unstructured":"Stratford PW, Binkley JM, Riddle DL. Health status measures: strategies and analytic methods for assessing change scores. Phys Ther. 1996;76(10):1109\u201323.","journal-title":"Phys Ther"},{"issue":"5","key":"4186_CR25","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1016\/S0895-4356(99)00206-1","volume":"53","author":"JA Husted","year":"2000","unstructured":"Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53(5):459\u201368.","journal-title":"J Clin Epidemiol"},{"issue":"3","key":"4186_CR26","first-page":"E59","volume":"46","author":"JA LaCross","year":"2022","unstructured":"LaCross JA, Borello-France D, Marchetti GF, Turner R, George S. Physical therapy management of functional constipation in adults: a 2021 evidence-based clinical practice guideline from the American physical therapy association\u2019s academy of. Pelvic Health Phys Therapy. 2022;46(3):E59-84.","journal-title":"Pelvic Health Phys Therapy"},{"issue":"7","key":"4186_CR27","doi-asserted-by":"publisher","first-page":"565","DOI":"10.5152\/tjg.2022.21342","volume":"33","author":"AH Gokce","year":"2022","unstructured":"Gokce AH, Gokce FS, Iliaz R, Gulaydin N. Transcutaneous tibial nerve stimulation as therapy for functional constipation. Turkish J Gastroenterology: Official J Turkish Soc Gastroenterol. 2022;33(7):565\u20139.","journal-title":"Turkish J Gastroenterology: Official J Turkish Soc Gastroenterol"},{"issue":"8","key":"4186_CR28","doi-asserted-by":"publisher","first-page":"760","DOI":"10.1111\/apt.15642","volume":"51","author":"JS Moore","year":"2020","unstructured":"Moore JS, Gibson PR, Burgell RE. Randomised clinical trial: transabdominal interferential electrical stimulation vs sham stimulation in women with functional constipation. Aliment Pharmacol Ther. 2020;51(8):760\u20139.","journal-title":"Aliment Pharmacol Ther"},{"issue":"1","key":"4186_CR29","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1016\/j.neurom.2024.10.009","volume":"28","author":"S Long","year":"2025","unstructured":"Long S, Ji S, Nojkov B, Chen JDZ. Efficacy and safety of noninvasive electrical neuromodulation for treatment of functional constipation: a systematic review and meta-analysis of randomized controlled trials. Neuromodulation. 2025;28(1):54\u201367.","journal-title":"Neuromodulation"},{"issue":"10","key":"4186_CR30","doi-asserted-by":"publisher","first-page":"e0330610","DOI":"10.1371\/journal.pone.0330610","volume":"20","author":"SS Babazadeh-Zavieh","year":"2025","unstructured":"Babazadeh-Zavieh SS, Karshenas F, Tayebi S, Rabiei N, Haeri SMJ. Effects of interferential stimulation on clinical symptom and urodynamic findings in women with voiding dysfunction: a protocol of randomized clinical trial. PLoS One. 2025;20(10):e0330610.","journal-title":"PLoS One"},{"key":"4186_CR31","doi-asserted-by":"crossref","unstructured":"Berghmans B, Seleme M. Background and effects of physical therapy for adult patients with Constipation, A systematic review. J Women\u2019s Health Dev. 2024;07:74-82.","DOI":"10.26502\/fjwhd.2644-288400123"},{"issue":"4","key":"4186_CR32","doi-asserted-by":"publisher","first-page":"478","DOI":"10.2522\/ptj.20160110","volume":"97","author":"SE George","year":"2017","unstructured":"George SE, Borello-France DF. Perspective on physical therapist management of functional constipation. Phys Ther. 2017;97(4):478\u201393.","journal-title":"Phys Ther"},{"issue":"3","key":"4186_CR33","first-page":"110","volume":"9","author":"SS Babazadeh-Zavieh","year":"2022","unstructured":"Babazadeh_Zavieh SS, Vasaghi-Gharamaleki B, Nikjooy A, Haeri SMJ, Sarrafzadeh J. Effects of pelvic floor Physiotherapy, with or without weight Loss, on urinary incontinence in obese women: A non-Randomized single blind clinical trial %J. J Rehabilitation Sci Res. 2022;9(3):110\u20137.","journal-title":"J Rehabilitation Sci Res"},{"key":"4186_CR34","doi-asserted-by":"publisher","first-page":"20","DOI":"10.1016\/j.ejogrb.2015.03.029","volume":"190","author":"B S\u00e1nchez S\u00e1nchez","year":"2015","unstructured":"S\u00e1nchez S\u00e1nchez B, Torres Lacomba M, Navarro Braz\u00e1lez B, Cerezo T\u00e9llez E, Pacheco Da Costa S, Guti\u00e9rrez Ortega C. Responsiveness of the Spanish pelvic floor distress inventory and pelvic floor impact questionnaires short forms (PFDI-20 and PFIQ-7) in women with pelvic floor disorders. Eur J Obstet Gynecol Reprod Biol. 2015;190:20\u20135.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"issue":"5","key":"4186_CR35","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1007\/s10620-017-4499-9","volume":"62","author":"D Khanna","year":"2017","unstructured":"Khanna D, Hays RD, Shreiner AB, Melmed GY, Chang L, Khanna PP, et al. Responsiveness to change and minimally important differences of the Patient-Reported outcomes measurement information system Gastrointestinal symptoms scales. Dig Dis Sci. 2017;62(5):1186\u201392.","journal-title":"Dig Dis Sci"},{"issue":"4","key":"4186_CR36","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.jht.2010.05.003","volume":"23","author":"LA Lehman","year":"2010","unstructured":"Lehman LA, Velozo CA. Ability to detect change in patient function: responsiveness designs and methods of calculation. J Hand Therapy: Official J Am Soc Hand Therapists. 2010;23(4):361\u201370. quiz 71.","journal-title":"J Hand Therapy: Official J Am Soc Hand Therapists"},{"issue":"9","key":"4186_CR37","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1097\/JTO.0b013e3181ec173d","volume":"5","author":"JN Mandrekar","year":"2010","unstructured":"Mandrekar JN. Receiver operating characteristic curve in diagnostic test assessment. J Thorac Oncology: Official Publication Int Association Study Lung Cancer. 2010;5(9):1315\u20136.","journal-title":"J Thorac Oncology: Official Publication Int Association Study Lung Cancer"},{"issue":"4","key":"4186_CR38","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1007\/s13312-011-0055-4","volume":"48","author":"R Kumar","year":"2011","unstructured":"Kumar R, Indrayan A. Receiver operating characteristic (ROC) curve for medical researchers. Indian Pediatr. 2011;48(4):277\u201387.","journal-title":"Indian Pediatr"},{"issue":"12","key":"4186_CR39","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1016\/j.ijsu.2014.07.014","volume":"12","author":"JP Vandenbroucke","year":"2014","unstructured":"Vandenbroucke JP, von Elm E, Altman DG, G\u00f8tzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. International journal of surgery (London, England). 2014;12(12):1500\u201324.","journal-title":"International journal of surgery (London, England)"},{"key":"4186_CR40","doi-asserted-by":"crossref","unstructured":"Mashayekh-Amiri S, Asghari Jafarabadi M, Rashidi F, Mirghafourvand MJBWH. Translation and measurement properties of the pelvic floor distress inventory-short form (PFDI-20) in Iranian reproductive age women. BMC Women's Health. 2023;23(1):1\u201311.","DOI":"10.1186\/s12905-023-02493-y"},{"key":"4186_CR41","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1016\/j.urology.2019.08.004","volume":"133","author":"R Lim","year":"2019","unstructured":"Lim R, Liong ML, Lim KK, Leong WS, Yuen KHJU. The minimum clinically important difference of the international consultation on incontinence questionnaires (ICIQ-UI SF and ICIQ-LUTSqol). Urology. 2019;133:91\u20135.","journal-title":"Urology"}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-025-04186-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-025-04186-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-025-04186-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T22:09:52Z","timestamp":1768342192000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12905-025-04186-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,5]]},"references-count":41,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["4186"],"URL":"https:\/\/doi.org\/10.1186\/s12905-025-04186-0","relation":{},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,5]]},"assertion":[{"value":"31 August 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 November 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study received the ethics approval from the Ethics Committee of Iran University of Medical Sciences (Code: IR.IUMS.REC.1403.055). It was performed according to the principles of the Declaration of Helsinki and all applicable regulatory standards. All participants were informed about the process and purposes of this study completely, then written informed consent was taken from every participant. Participation was entirely voluntary, with the option for participants to withdraw from the study at any point without any penalty.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The authors declare no financial or other interests. This study is extracted from the master of science (M.Sc) thesis of Fahimeh Karshenas.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"20"}}