[The Effectiveness of Abdominal Massage on Neurogenic Bowel Dysfunction in Patients With Spinal Cord Injury: A Systematic Review].
BACKGROUND
Neurogenic bowel dysfunction is a common comorbidity in spinal cord injury patients that may result in fecal incontinence. Abdominal massage is one intestinal training method that is used to improve bowel movement and defecation.


OBJECTIVE
To review the effectiveness of abdominal massage on neurogenic bowel dysfunction in patients with spinal cord injury.


METHODS
A systematic review of Chinese and English-language articles was performed in six databases using the following key words: spinal cord injury, abdominal massage, neurogenic bowel dysfunction, and bowel training. Relevant studies published prior to June 2016 that met the inclusion and exclusion criteria were selected. The Downs and Black scale was used to appraise the quality of each of the included studies. Eight studies were included in the final analysis.


RESULTS
Four of these studies indicated that abdominal massage significantly improved bowel functions and the regularity and frequency of bowel movements. Although two of the studies indicated that abdominal massage significantly reduced the use of glycerin and laxatives, the remaining six did not. The eight studies earned respective quality scores ranging between 13 and 25.


CONCLUSIONS
The current literature lacks consensus on the efficacy of abdominal massage in terms of improving bowel dysfunction in patients with spinal cord injuries. Future studies should use more stringent experimental designs such as randomized controlled studies to explore the correlations among massage time and frequency and bowel function improvements in order to provide guidelines for clinical care applications.
Department of Nursing, Chung Shan Medical University Hospital, and Adjunct Instructor, School of Nursing, Chung Shan Medical University, and Doctoral Student, School of Nursing, Kaohsiung Medical University, Taiwan, ROC.
Tzu-Jung
TJ
Wu
School of Nursing, Kaohsiung Medical University, Taiwan, ROC.
Chiu-Chu
CC
Lin
School of Nursing, and Vice President, Kaohsiung Medical University, Taiwan, ROC. hhwang@kmu.edu.tw.
Hsiu-Hung
HH
Wang
D006801:Humans; D008405:Massage; D055496:Neurogenic Bowel / Q000628:therapy*; D013119:Spinal Cord Injuries / Q000150:complications* / Q000628:therapy
abdominal massage; neurogenic bowel dysfunction; spinal cord injury