The effectiveness of walking exercise on the bowel preparation before colonoscopy: A single blind randomized clinical trial study

Abstract

Background and aim: Bowel preparation is a crucial factor affecting the diagnostic accuracy of colonoscopy, and few randomized control trials evaluated enhancement in bowel preparation. In this study, we aimed to evaluate the effectiveness of walking exercises on bowel preparation before colonoscopy procedure. Methods: The present study is a single-blind randomized control trial, including 262 patients undergoing colonoscopy procedure. Patients were randomly divided into two groups of intervention (n=131) and control (n=131). Individuals in the intervention group were supposed to consume certain liquids and foods, bisacodyl pills, poly ethylene glycol powder and walk before their colonoscopy day based on a predefined plan. Individuals in the control group were supposed to consume the same regimen as the intervention group but were not told to do walking exercises. On the colonoscopy day, both groups were estimated regarding the number of footsteps taken by a foot counter. An experienced gastroenterologist compared the two groups regarding the Boston Bowel Preparation Scale (BBPS). Results: The number of taken footsteps in the two groups was significantly different (P<0.001). Although there was no significant difference between the intervention and control groups regarding mean BBPS (6.26±1.9 vs 6.29±1.9, P =0.416), individuals with more than 6900 steps had significantly higher BBPS compared to individuals with less than 6900 footsteps (6.62±1.8 vs 5.92±1.9, P = 0.003). In univariate analysis, BBPS was significantly associated with age below 50 (OR: 2.45, 95%CI: 1.30-4.61, P=0.006) and smoking (OR: 0.41, 95%CI: 0.17-0.94, P=0.043). In multivariate analysis, the relationship between BBPS with age below 50 and smoking remained significant (OR: 2.50, 95%CI: 1.30-4.70, P=0.005 and OR: 0.38, 95%CI: 0.16-0.93, P=0.034, respectively). Conclusion: Although walking exercise as an intervention before colonoscopy was not significantly associated with BBPS, the higher number of footsteps taken was found to enhance bowel preparation. Also, older people and smokers seem to have fewer benefits from walking exercises for bowel preparation before the colonoscopy procedure. Trial registration: ISRCTN32724024 (Registration date:22/08/2018).