Abdominal Massage
Discussion
Ayas and colleagues (2006) reported on individuals with SCI who received at least 15 minutes of abdominal massage beginning at the cecum and extending along the length of the colon to the rectum during their regular bowel routine. Differences were found in the frequency of defecation and mean colonic transit time between phase I, when subjects participated in a standard bowel program in which they received a standard diet containing 15-20 g of fiber/day and underwent daily digital stimulation, and phase II, when the subjects continued to receive this standard care and had the addition of abdominal massage when attempting bowel evacuation. However, these differences were statistically insignificant, possibly due to a small and heterogeneous sample. In the study by Hu et al. (2013), manual therapy was applied to the intestine and along the colon. A statistically significant improvement was seen in the meantime of bowel movement as well as dosage of glycerine enema needed. The sample in this study was also very small but was homogenous. Further suitably powered studies are required in the SCI population to determine the effectiveness of abdominal massage as an intervention for neurogenic bowel dysfunction.
Conclusion
There is level 4 evidence (from one pre-post study; N=24) (Ayas et al. 2006) that abdominal massage is ineffective for treating the neurogenic bowel.
There is conflicting level 4 evidence (from one pre-post study; N=20) (Hu et al. 2013) that abdominal massage is effective in reducing bowel movement time as well as dosage of glycerine enemas.
