The effects of abdominal "I LOV U" massage along with lifestyle training on constipation and distension in the elderly with stroke

Influencing Factors of Constipation in Elderly Patients With Intracerebral Hemorrhage: Implication for Clinical Care

Background: Constipation is common in elderly inpatients with intracerebral hemorrhage. This study aimed to construct a model for predicting the risk of constipation in elderly inpatients with intracerebral hemorrhage and to provide reference for formulating targeted intervention measures. Methods: Elderly patients with intracerebral hemorrhage who were treated in the department of Neurosurgery of a third-class hospital in Suzhou from January 2018 to September 2023 were included. Clinical data of patients with and without constipation were compared. Logistic regression analysis was used to explore the influencing factors of constipation in elderly patients with intracerebral hemorrhage, and R software was used to construct a line chart model to verify its predictive effect. Results: A total of 504 elderly patients with intracerebral hemorrhage were included. The incidence of constipation in elderly patients with cerebral hemorrhage was 63.9%. Logistic regression analysis showed that GCS score (OR = 1.094, 95%CI: 1.019∼1.174), hypertension (OR = 2.911, 95%CI: 1.797∼4.715), use of dehydrating agent (OR = 3.794, 95%CI: 2.337∼6.158), surgical treatment (OR = 3.986, 95%CI: 2.339∼6.793), use of sedative drugs (OR = 4.212, 95%CI:2.386-7.435), and limb paralysis (OR = 6.313, 95%CI:3.689∼10.803) were the independent risk factors for constipation in elderly patients with intracerebral hemorrhage. The area under the ROC curve of the prediction model was 0.872 (95%CI: 0.8401∼0.9033), the best critical value was 0.705, the sensitivity was 0.748, and the specificity was 0.857. Conclusion: The constipation risk prediction model of elderly patients with cerebral hemorrhage has good differentiation and calibration, which is helpful for health care providers to identify the risk of constipation in elderly patients with intracerebral hemorrhage.

Effectiveness of acupoint stimulation combined with neurogenic bowel training on constipation in stroke patients: a retrospective study

OBJECTIVE

To analyze the effectiveness of acupoint stimulation combined with neurogenic bowel training on constipation in stroke patients.

METHODS

A retrospective analysis was conducted on the clinical data of 89 stroke patients with constipation admitted to our hospital from July 2022 to January 2024. All patients met the inclusion and exclusion criteria. The control group (n = 42) received neurogenic bowel training intervention, while the experimental group (n = 47) received finger acupoint stimulation combined with neurogenic bowel training intervention. Four outcome measures including intervention effects, bowel movements, Constipation Scoring System (CSS), and Scores on the Patient Assessment of Constipation Quality of Life (PAC-QOL) were compared between the two groups.

RESULTS

The total intervention effective rate in the experimental group (91.49%) was significantly higher than that in the control group (73.81%) (p < 0.05). Two weeks after intervention, the experimental group had significantly better first bowel movement time, average bowel movement time, and bowel movement interval time compared to the control group (p < 0.05). One and 2 weeks after intervention, the CSS and PAC-QOL scores in the experimental group were significantly better than those in the control group (p < 0.05).

CONCLUSION

Acupoint stimulation combined with neurogenic bowel training significantly improves constipation in stroke patients. Compared to neurogenic bowel training alone, the combined application of acupoint stimulation further improves bowel movements, reduces constipation severity, and enhances the quality of life in patients. Therefore, it is worthy of clinical promotion.

Comparison of the effects of abdominal massage and osteopathic manipulative treatment home program on constipation in children with cerebral palsy

Background and Aim

The aim of this study is to compare the effects of osteopathic manipulative therapy home program (OMT-H) versus abdominal massage home program (AMHP) in treating constipation in children with cerebral palsy (CP).

Methods

Twenty-nine children with CP with a mean age of 12.2 ± 3.76 years, who were constipated and were not on medication, were divided into three randomized groups: (i) control group (n = 10), (ii) AMHP (n = 10), and (iii) OMT-H (n = 9). In AMHP and OMT-H groups, treatment was applied as 20-min sessions every other day for 10 sessions for 3 weeks. Modified Constipation Assessment Scale (MCAS), Rome III criteria, and the Bristol Stool Form Scale (BSFS) were used for evaluation before treatment and once a week during treatment.

Results

While there was no change in constipation symptoms in the control group, there was an improvement in constipation symptoms after treatment in the AMHP and OMT-H groups (AMHP, P = 0.003; OMT-H, P = 0.000014). While the treatment showed to be effective from the first week in the OMT-H group, the change in BSFS (P = 0.026) and MCAS sub-parameters was found to be superior.

Conclusion

AMHP and OMT-H are effective and beneficial in treating constipation. In children with CP, OMT-H was found to be quicker and more successful compared with AMHP. The OMT-H can be effectively used in clinical practice in relieving constipation in CP.

Clinical effects and safety of semi-solid feeds in tube-fed patients: a meta-analysis and systematic review

Background

Enteral nutrition is a very important form of treatment for critically ill patients. This meta-analysis aimed to evaluate the clinical effects and safety of semi-solid feeds in tube-fed patients.

Methods

Two researchers searched PubMed, clinical trials, Embase, Cochrane Central Register of Controlled Trials, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Weipu databases for randomized controlled trials (RCTs) on the clinical effects and safety of semi-solid feeds in tube-fed patients until 10 October 2023. The quality evaluation tool recommended by the Cochrane Library was used to evaluate the quality of included RCTs. RevMan 5.4 software was used for data analysis.

Results

A total of eight RCTs involving 823 tube-fed patients were included in this meta-analysis. A synthesized outcome indicated that semi-solid feeds reduced the incidence of diarrhea (RR = 0.32, 95%CI:0.20-0.50, P < 0.001), vomiting (RR = 0.31, 95%CI:0.15-0.64, P = 0.002), abdominal distension (RR = 0.41, 95%CI:0.22-0.76, P = 0.005), length of intensive care unit (ICU) stay (MD = -3.61, 95%CI: -6.74 to -0.48, P = 0.02), and length of hospital stay (MD = -7.14, 95%CI: -10.31 to -3.97, P < 0.01) in tube-fed patients. Enteric feeding had no effect on the 30-day mortality (RR = 0.55, 95%CI: 0.19-1.56, P = 0.26). No publication bias was detected by the Egger's test results (all P > 0.05).

Conclusion

Semi-solid feeds are beneficial in reducing the incidence of diarrhea, abdominal distension, vomiting, and hospital stay. More high-quality studies are needed in the future to verify the effects of semi-solid feeds on mortality.

Effect of Prolong-life-with-nine-turn-method (Yan Nian Jiu Zhuan) Qigong on fatigue and gastrointestinal function in patients with chronic fatigue syndrome: Study protocol for a randomized controlled trial

INTRODUCTION

Chronic fatigue syndrome (CFS) is a physical and mental disorder in which long-term fatigue is the main symptom. CFS patients are often accompanied by functional gastrointestinal diseases (FGIDs), which lead to decreased quality of life and increased fatigue. Prolong-life-with-nine-turn-method (PLWNT) is a kind of physical and mental exercise. Its operation includes adjusting the mind, breathing and cooperating with eight self-rubbing methods and one upper body rocking method. PLWNT was used to improve the digestive function in ancient China and to treat FGIDs such as functional dyspepsia and irritable bowel syndrome in modern times. Previous studies have shown that PLWNT can reduce fatigue in patients with CFS. But it is unclear whether the effect of PLWNT on CFS fatigue is related to gastrointestinal function. The aim of this study was to explore the relationship between PLWNT and fatigue and gastrointestinal function in patients with CFS.

METHODS

This study is a non-inferiority randomized controlled trial (RCT). The whole study period is 38 weeks, including 2 weeks of baseline evaluation, 12 weeks of intervention and 6 months of follow-up. Ninety-six CFS patients will be stratified random assigned to the intervention group (PLWNT) and the control group (cognitive behavior treatment) in the ratio of 1:1 through the random number table generated by SPSS. In the evaluation of results, Multidimensional Fatigue Inventory-20 (MFI-20), Gastrointestinal Symptom Rating Scale (GSRS), Bristol Stool Form Scale (BSFS), and Short Form 36 item health survey (SF-36) will be evaluated at week 0 (baseline), week 6 (midterm), week 12 (endpoint) and month 9 (follow up). The intestinal flora will be evaluated at week 0 (baseline) and week 12 (endpoint). The data results will be processed by statistical experts. The data analysis will be based on the intention to treat principle and per-protocol analysis. In the efficacy evaluation, repeated measurement analysis of variance will be used for data conforming to normal distribution or approximate normal distribution. The data which do not conform to the analysis of repeated measurement variance will be analyzed by the generalized estimation equation Linear discriminant analysis will be used to clarify the difference species of intestinal flora. The significance level sets as 5%. The safety of interventions will be evaluated after each treatment session.

DISCUSSION

This trial will provide evidence to PLWNT exerting positive effects on fatigue and gastrointestinal function of CFS. It will further explore whether the improvement of PLWNT on CFS fatigue is related to gastrointestinal function.

TRIAL REGISTRATION

The trial was registered at Chinese Clinical Trial Registry http://www.chictr.org.cn/showproj.aspx?proj=151456 (Registration No.: ChiCTR2200056530). Date: 2022-02-07.

Effectiveness and safety of digital rectal stimulation and abdominal massage for neurogenic bowel dysfunction in stroke patients: a randomized controlled trial protocol

BACKGROUND

Neurogenic bowel dysfunction (NBD) is a prevalent complication among stroke patients, significantly affecting their quality of life, duration of hospitalization, medical expenses, and even mortality. Although current guidelines suggest a conservative strategy for addressing bowel dysfunction, which includes techniques such as digital rectal stimulation (DRS) and abdominal massage, the availability of interventions remains limited in healthcare facilities.

METHODS

This study follows a prospective randomized controlled parallel-group clinical trial design. The control group will receive standard care, while the intervention group will undergo a program that combines DRS and abdominal massage in addition to standard care. The duration of the intervention for both groups will be 6 weeks. The primary outcome measures will be the Wexner score. Furthermore, secondary outcomes measure will be assessed, including Bristol score, Patient Assessment of Constipation-Quality of Life (PAC-QoL), and Fecal Incontinence Quality of Life (FI-QoL).

DISCUSSION

This study aims to evaluate the effectiveness and safety of a bowel rehabilitation program for stroke patients with NBD. The findings will provide information that can contribute to the formulation of bowel management strategies.

TRIAL REGISTRATION

The study has been registered in the Chinese Clinical Registry under the number ChiCTR2300071709. This registration was completed on May 23, 2023. All items from the World Health Organization Trial Registration Data set are described in this manuscript.

Analysis of the efficacy of abdominal massage on functional constipation: A meta-analysis

Background

Constipation is a digestive disorder with a high global prevalence, with approximately 20-25% of the population suffering from constipation, and the majority of constipated patients experience functional constipation (FC). Although abdominal massage is an effective intervention, there is a lack of analysis of the efficacy of abdominal massage in the treatment of functional constipation. Objective: To evaluate the clinical efficacy of abdominal massage in the treatment of functional constipation.

Methods

A computerized retrieval of randomized controlled trials on abdominal massage for functional constipation was conducted on China National Knowledge Infrastructure (CNKI), Wanfang, VIP Chinese Science and Technology Periodical Database, Chinese BioMedical Literature Database, Cochrane Database, PubMed, Embase, and Web of Science until October 1, 2022. Meta-analysis was performed using RevMan 5.3 software after the initial screening and re-screening of the literature.

Results

A total of 13 papers involving 830 patients were included. The results of the meta-analysis showed that abdominal massage had better efficacy in the treatment of functional constipation. Constipated patients in the treatment group showed greater improvement in the frequency of defecation, difficulty in defecation, stool properties, and PAC-QOL scores than those in the control group. The SMD/MD values and 95% CI of each score were: SMD = 1.05, 95%CI (0.63,1.46); SMD = -1.51, 95%CI (-2.35,-0.68); SMD = 0.95, 95%CI (0.31,1.59); MD = -13.24, 95%CI (-25.83, -0.65).

Conclusion

Abdominal massage can increase the frequency of defecation, reduce the symptoms of difficulty in defecation, improve stool properties, and positively affect the quality of life of patients with constipation. Hence, abdominal massage therapy shows definite therapeutic efficacy for functional constipation, providing a more specific plan for clinical treatment.

STandards for Reporting Interventions in Clinical Trials Of Tuina/Massage (STRICTOTM): Extending the CONSORT statement

OBJECTIVES

Massage is a common therapy of nonpharmacological treatments, particularly in Tuina (Chinese massage) as its most common style, detailed guidance in reporting the intervention is warranted for its evaluation and replication. Based on the CONSORT (Consolidated Standards of Reporting Trials), we aimed to develop an Extension for Tuina/Massage, namely "The STandards for Reporting Interventions in Clinical Trials Of Tuina/Massage (STRICTOTM)."

METHODS

A group of professional clinicians, trialists, methodologists, developers of reporting guidelines, epidemiologists, statisticians, and editors has developed this STRICTOTM checklist through a standard methodology process recommended by the EQUATOR (Enhancing the QUAlity and Transparency of Health Research) Network, including prospective registration, literature review, draft of the initial items, three rounds of the Delphi survey, consensus meeting, pilot test, and finalization of the guideline.

RESULTS

A checklist of seven items (namely Tuina/Massage rationale, details of Tuina/Massage, intervention regimen, other components of the intervention, Tuina/Massage provider background, control or comparator interventions, and precaution measures), and 16 subitems were developed. Explanations and examples (E&E) for each item are also provided.

CONCLUSIONS

The working group hopes that the STRICTOTM, in conjunction with both the CONSORT statement and extension for nonpharmacologic treatment, can improve the reporting quality and transparency of Tuina/Massage clinical research.

Abdominal massage: A review of clinical and experimental studies from 1990 to 2021

OBJECTIVE

To systematically review the current state and holistic application of abdominal massage (AM).

DESIGN

A systematic review of qualitative evidence was conducted. All English articles exploring the topic of AM that had been published until the end of June 2021 were retrieved.

DATA SOURCES

The PubMed, Cochrane library, and Embase databases were accessed. Some original texts were obtained from Google Scholar.

DATA EXTRACTION AND SYNTHESIS

Two authors independently evaluated all search data to identify relevant studies. Disagreements were settled by discussion with a third author. Results were independently extracted into standardized sheets and checked for accuracy.

MAIN RESULTS

A total of 107 full-text reports were eligible for inclusion. Adult digestive disorders, pediatric disorders, gynecological disorders, obstetric disorders, metabolic disorders, psychological disorders, the side effects of AM, and animal experiments accounted for 49.53%, 14.02%, 7.48%, 7.48%, 4.67%, 4.67%, 5.61%, and 6.54% of all these papers, respectively, with most reports focusing on clinical studies.

CONCLUSION

The variety of diseases treated with AM is gradually increasing, and the treatment programs of AM for many diseases are being gradually optimized. Different forms of AM, especially mechanical AM, have been widely studied; the side effects of AM have also been considered; and the possible mechanisms of AM therapy continue to be discovered. In general, AM is an effective and safe therapy and can be widely used in various diseases, but further studies are necessary to clarify the mechanism of AM for different diseases. In the future, AM could become an even safer, more popular, and more modern therapy.