Abdominal massage for the alleviation of constipation in people with multiple sclerosis: a randomized controlled feasibility study

Author(s): D. McClurg, S. Hagen, S. Hawkins & A. Lowe-Strong - Pages: 14–15

Abstract

Abdominal massage is used to relieve the symptoms of constipation in several patient populations (Ernst 1999; Lamas et al. 2009). However, although constipation is a major problem for people with multiple sclerosis (MS), there have been no previous studies on the use of the technique in this population (Chia et al. 1995). Thirty people with MS were recruited for a feasibility study over a 6-month period. Patients self-referred and were included if they fulfilled the Rome II criteria for constipation. Following completion of the consent form and the recording of baseline outcome measures, the participants were randomly allocated to two groups: (1) the intervention group (n = 15), who received 4 weeks of abdominal massage and lifestyle advice; and (2) the control group (n = 15), who received lifestyle advice alone. A physiotherapist made weekly home visits to all the participants for the 4 weeks of intervention. The intervention group were either taught how to deliver the abdominal massage themselves or their carers were trained in the technique. It was recommended that the massage should be performed daily and that each session should last for 15 min. A DVD was also provided that demonstrated the abdominal massage. The outcome measures were recorded at weeks 0 (baseline), 4 and 8 by a research assistant who was blinded to the group allocation. The Constipation Scoring System (CSS) was the primary outcome measure, and the others were the Neurogenic Bowel Dysfunction Score and a bowel diary. The CSS scores and frequency of defecation improved in both groups over the intervention period; however, by week 4, this improvement was only statistically significant in the treatment group (P = 0.003 and P = 0.001 for groups 1 and 2, respectively). The questionnaire response rates and compliance with treatment were high, and the results of the data analysis indicate that abdominal massage had a potentially positive effect on the symptoms of constipation.

Keywords: bowel dysfunction, continence, neurology.