Spinal Cord Injuries, Traditional Chinese Medicine
Conditions
Keywords
Spinal cord injury, Acupressure, Community-dwelling, Traditional Chinese Medicine
Brief summary
Spinal cord injury is a multi-sensory, motor and autonomic dysfunction, caused by various types of acute and chronic central nervous system injuries. And it will affect patient's ability to live normally and return to society. Due to lack of physical activity and psychological and environmental factors, the feces remain in the intestine for too long, and there will be excessive water absorption and lead to dryness and difficulty in excretion and it will be constipation. Chinese medicine, acupuncture and acupressure are the treatments of constipation in Traditional Chinese Medicine. Acupressure is a non- invasive intervention which is easy to learn and apply. We have carried out a number of studies on spinal cord injury rehabilitation support and acupressure to solve chronic problems such as constipation and anxiety. And this study aims to investigate the effects of acupressure combined with nursing intervention on constipation and quality of life in community-dwelling spinal cord injury patients.
Detailed description
This study will use an open-label, double-group, randomized controlled trial to compare the effect of the intervention group with the control group. Study participants will be recruited from the Hong Kong Direction Association for the Handicapped, a non-governmental organization dedicated to serving severely disabled Hong Kong people such as SCI. The sociodemographic data, disease status and outcome indicators of the study subjects were measured before the intervention, after the intervention and one month after the intervention. Research assistants (RA1) were trained to evaluate data and data, blinded to group assignments. We will have the focus group interviews (semi-structured) with participants after the the intervention (post-intervention). The interviews will be conducted online to further understand the benefits and limitations of the research intervention.
Interventions
OTHERHome-based, manual light touch of the abdomen combined with nursing education
Control group or their caregivers will apply the manual light touch to the abdomen in any direction or body position at home. In keeping consistent with the intervention group, abdomen touching will also be administered twice daily for approximately 15 minutes each for 10 days. Participants will also receive nursing education.
OTHERHome-based, acupressure combined with nursing education
The intervention group will focus on 11 acupoints on the abdomen (RN12, RN4, ST25), back (BL20, BL21, BL22, BL23, BL24, BL25), and limbs (LI4, ST36). The participants or their caregivers can perform acupressure 30 minutes after meals and twice a day. Participants can choose between two sets of acupressure: (1) Acupressure of the abdominal and back acupoints in a seated position, or (2) Acupressure of the abdominal and limb acupoints in a supine position. Each session lasts approximately 15 minutes. Besides, the intervention group will also receive nursing education on the basis of receiving acupressure intervention including (1) dietary guidance: help patients to formulate a reasonable diet plan, (2) cultivate regular defecation habits, (3) understand appropriate defecation environments and postures, and (4) Moderate exercise to increase gastrointestinal motility.
Sponsors
The Hong Kong Polytechnic University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
We aim to have two study group, including the intervention group that receive acupressure combined with nursing interventions, and the control group that receive acupressure on sham acupoints combined with nursing interventions
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. being Hong Kong residents between the ages of 18 or older, 2. having an SCI diagnosis for over 6 months and living in the community, 3. demonstrating the willingness and ability to learn and engage in acupressure (or having a caregiver to assist if self-operating is not feasible), 4. experiencing difficulties with defecation or having concerns related to defecation.
Exclusion criteria
1. currently undergoing other TCM treatments or receiving interventions related to defecation or bowel functions, 2. being unable to attend the training sessions due to personal reasons, 3. having a history of gastrointestinal organic disease, 4. having severe metabolic diseases, cardiovascular, cerebrovascular, or mental illnesses
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The severity of constipation at baseline | The severity of constipation will be assessed at baseline assessment. | Constipation Assessment Scale (CAS) will be used to measure the severity of constipation of the Spinal cord injury participants, 0 indicated no problem, 1 indicated some problem, 2 indicated severe problem. High scores will indicated the more severe condition of constipation. |
| The severity of constipation at post-intervention | The severity of constipation will be assessed after 10 days intervention. | Constipation Assessment Scale (CAS) will be used to measure the severity of constipation of the Spinal cord injury participants, 0 indicated no problem, 1 indicated some problem, 2 indicated severe problem. High scores will indicated the more severe condition of constipation. |
| The severity of constipation at one month follow-up | The severity of constipation will be assessed after one month follow-up. | Constipation Assessment Scale (CAS) will be used to measure the severity of constipation of the Spinal cord injury participants, 0 indicated no problem, 1 indicated some problem, 2 indicated severe problem. High scores will indicated the more severe condition of constipation. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Psychosocial well-being at baseline | Psychosocial well-being will be assessed at baseline assessment. | The Depression Anxiety Stress Scale (DASS) will be used to measure participants' psychosocial well-being. The scale investigates the negative emotional experience or the corresponding physiological response in the last week. |
| Psychosocial well-being at post-intervention | Psychosocial well-being will be assessed after 10 days intervention. | The Depression Anxiety Stress Scale (DASS) will be used to measure participants' psychosocial well-being. The scale investigates the negative emotional experience or the corresponding physiological response in the last week. |
| Psychosocial well-being at one month follow-up | Psychosocial well-being will be assessed after one month follow-up | The Depression Anxiety Stress Scale (DASS) will be used to measure participants' psychosocial well-being. The scale investigates the negative emotional experience or the corresponding physiological response in the last week. |
| Quality of life at baseline | Quality of life will be assessed at baseline assessment. | The Patient Assessment of Constipation Quality of Life Questionnaire will be used to measure the quality of life of Spinal cord injury participants. The scale investigates the quality of life of people in the past two weeks, using a 5-point Likert scale, assigning 0-4 points for various discomforts from not at all to extremely. Each domain score and total score are the average scores of the domain items and all items, respectively. Higher scores indicate poorer quality of life. |
| Bowel habit at post-intervention | Bowel habit will be assessed after 10 days intervention. | Bowel habits will be assessed during each visit by recording the frequency of laxative and glycerine enema use, as well as the frequency and duration of defecation in the past week. |
| Bowel habit at one month follow-up | Bowel habit will be assessed after one month follow-up. | Bowel habits will be assessed during each visit by recording the frequency of laxative and glycerine enema use, as well as the frequency and duration of defecation in the past week. |
| Bowel habit at baseline | Bowel habit will be assessed at baseline assessment. | Bowel habits will be assessed during each visit by recording the frequency of laxative and glycerine enema use, as well as the frequency and duration of defecation in the past week. |
| Quality of life at post-intervention | Quality of life will be assessed after 10 days intervention. | The Patient Assessment of Constipation Quality of Life Questionnaire will be used to measure the quality of life of Spinal cord injury participants. The scale investigates the quality of life of people in the past two weeks, using a 5-point Likert scale, assigning 0-4 points for various discomforts from not at all to extremely. Each domain score and total score are the average scores of the domain items and all items, respectively. Higher scores indicate poorer quality of life. |
| Quality of life at one month follow-up | Quality of life will be assessed after one month follow-up. | The Patient Assessment of Constipation Quality of Life Questionnaire will be used to measure the quality of life of Spinal cord injury participants. The scale investigates the quality of life of people in the past two weeks, using a 5-point Likert scale, assigning 0-4 points for various discomforts from not at all to extremely. Each domain score and total score are the average scores of the domain items and all items, respectively. Higher scores indicate poorer quality of life. |
Countries
Hong Kong
Outcome results
None listed