Effects of abdominal massage on constipation in palliative care patients – a pilot study

Abstract

Introduction: The problem of constipation in Poland concerns 13.4% of the healthy population. In the case of patients treated with opioids, this number increases to 70-90%, which constitutes a serious problem that lowers the patients’ quality of life. The aim of the study was to assess the effects of abdominal massage, which successfully reduces constipation in various diseases, on palliative care patients. Material and methods: The research included 18 patients of a palliative care facility (mean age 78.3 ± 10 years), 11 of whom completed the study. The study participants were randomly divided into two groups, i.e. a pilot group (abdominal massage and kinesiotherapy) and a control group (kinesiotherapy). The therapy lasted 8 weeks and blind evaluation was carried out once per week. The study involved evaluating constipation intensity (The Bowel Function Index), the frequency of defecation (medical documentation) and abdomen circumference (anthropometric tape). The collected data were analysed statistically with the use of Statistica software. Results: The observed differences between the studied groups undergoing different therapies in subsequent weeks were not statistically significant. However, in the group in which abdominal massage was implemented, a decrease in the intensity of constipation, an increase in the frequency of defecation and a reduction in abdomen circumference were noted compared to the control group. The patients also indicated additional positive effects of this form of therapy, i.e. an improvement in breathing, easier urination, release of excessive gas and abdominal pain reduction. Conclusions: The collected data led to the conclusion that abdominal massage may result in a decrease in disorders accompanying opioid-induced constipation. Therefore, it is worth considering the implementation of this form of therapy in the case of patients in an advanced stage of cancer. There is also a need for further research in this field which will include a larger number of patients.

The effectiveness of aromatherapy, massage and reflexology in people with palliative care needs: A systematic review

“…These included, for example, studies of healthy populations, and patient populations with progressive diseases but not at a palliative stage. Twenty-two RCTs met the inclusion criteria 17–38 (Figure 1).…”

“…21 In the 12 trials involving massage, sessions ranged from three 15- to 45-min massages 25,28 to a 15-min massage daily for 8 weeks. 37 All of the studies that described the setting were conducted in the participants’ homes. 24,28,29,38 Interventions were delivered by massage therapists, other than one study that involved nurses, 25 and one that did not describe the interventionist.…”

“…Some findings are not reported for six trials because there were baseline differences between trial arms that were not controlled for in all or some of the analyses. 17,18,22,23,37,38 In one trial, findings were not reported as it did not assess any of our outcomes of interest. 36 The trial focused on physiological outcomes such as heart rate.…”

Complementary therapy in palliative care: A synthesis of qualitative and quantitative systematic reviews

“…None of the eight trials' intervention arms included all four key components. Four of the eight trials reported 14 Goepfert et al 15 Kyle 16 Lai et al 17 Serfaty et al 18 Soden et al 19 Wilcock et al 20 Wilkinson et al 21 Massage Dadura 2017 23 Downey 2009 22 Jane et al 24 Kolcaba et al 25 Kutner et al 26 Toth et al 27 Wilkie et al 28 Williams et al 29…”

“…every day). 22 – 24 , 26 , 28 , 29 Three provided some form of choice including massage location on the body, pressure and choice of oils. 22 , 27 , 29 No trial reported encouraging interaction; two specified no interaction was allowed or encouraged.…”