Effectiveness and safety of digital rectal stimulation and abdominal massage for neurogenic bowel dysfunction in stroke patients: a randomized controlled trial protocol

Abstract

Abstract Background Neurogenic bowel dysfunction (NBD) is a prevalent complication among stroke patients, significantly affecting their quality of life, hospitalization duration, medical expenses, and even mortality. Although current guidelines suggest a conservative approach to managing bowel dysfunction, incorporating techniques such as digital rectal stimulation (DRS) and abdominal massage, the availability of other interventions remains limited in healthcare facilities. Therefore, it’s crucial to develop accessible and targeted rehabilitation programs that can improve both bowel function and quality of life for stroke patients. The aim of this study is to evaluate the effectiveness of a 6-week rehabilitation program for stroke patients with NBD. Methods This study employs a prospective randomized controlled parallel-group clinical trial design. The control group will receive standard care, while the intervention group will undergo a program that combines DRS and abdominal massage in addition to standard care. The duration of the intervention for both groups will be a period of 6 weeks. To assess the efficacy of the intervention, participants from both groups will be evaluated at four time points: baseline, week 2, week 6, and week 12. The primary outcome will be the Wexner score. Additionally, secondary outcomes will be assessed, including the Bristol score, Patient Assessment of Constipation-Quality of Life (PAC-QoL), and Fecal Incontinence-Quality of Life (FI-QoL). Discussion This study aims to evaluate the safety and efficacy of a bowel rehabilitation program for stroke patients with NBD. Results will provide valuable information for developing optimal treatment strategies. Trial registration ChiCTR2300071709. Registered on 23 May 2023