A Systematic Review of Exercise Therapy for Bowel Preparation

Abstract

This systematic review aims to evaluate (1) the effectiveness of exercise therapy in bowel preparation for colonoscopy, and (2) the characteristics of exercise programs for bowel preparation. Systematic searches were done in PubMed, EMBASE, the Cochrane Library, Web of Science, and CINAHL from inception to November 2022. Randomized controlled trials and quasi-experimental studies assessing the efficacy of exercise during bowel preparation were included in this review. Two reviewers independently assessed the methodological quality using a modified Downs and Black checklist. A narrative synthesis was conducted. A total of five studies (1,109 participants) were included in this review. In all eligible studies, the characteristics of the exercise programs varied and included mainly two types of exercise (walking and yoga), various amount of exercise (3,000–10,000 steps or 0.5–1.9 hours), and two exercise timing (during and 1 hour after taking the laxative). Available evidence indicated that exercise therapy is effective in improving the quality of bowel preparation. However, there was insufficient high-quality evidence to conclude the effects on procedure-related indicators, adverse events, and willingness to repeat preparation. Exercise should be recommended as an important part of routine bowel preparation for patients undergoing colonoscopy to improve the quality of bowel preparation. More rigorous studies focusing on the effects on procedure-related indicators, adverse events, and willingness to repeat preparation are needed. To ensure the effectiveness and safety of the intervention, it is critical to establish a standard, well-structured exercise program for bowel preparation.

An abdominal vibration combined with walking exercise (AVCWE) program for older patients with constipation: Development and feasibility study

“…Walking exercise has demonstrated its effectiveness in enhancing bowel preparation for colonoscopy by promoting gastrointestinal motility and bowel movements through specific parameters such as walking intensity, duration, or step count. [ 19 ] A prospective observational study of 150 Chinese outpatients undergoing colonoscopies identified 5,270 steps as the minimum requirement for achieving high-quality bowel cleansing. [ 27 ] Similarly, Gao et al .…”

“…Furthermore, the current studies predominantly analyzed the effects of either walking exercise or abdominal vibration in isolation, without investigating their combined effects. [ 19 20 ] Given the challenges faced by older patients with constipation in achieving adequate bowel cleansing, a more intensive intervention combining abdominal vibration and walking exercises may hold promise for this population. Based on existing literature and extensive clinical experience, the researchers initially developed the original AVCWE protocol, which was subsequently validated by a multidisciplinary expert panel.…”

“…Recently, some nonpharmacological methods, such as walking exercise and abdominal vibration, have shown promise in improving bowel cleansing and reducing adverse events during preparation. [ 19 20 ] However, no similar studies have been conducted to date specifically focusing on older patients with constipation. Moreover, previous literature has primarily examined the effects of walking exercise or abdominal vibration separately on bowel preparation quality in the general population.…”