Effect of Acupressure on Constipation in Community-dwelling Spinal Cord Injury Patients: a Randomized Controlled Trial

NCT05558657 | Completed

• 1 other identifier: P0035107
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

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.

Conditions

Spinal Cord Injuries; Traditional Chinese Medicine

Keywords

Spinal cord injury; Acupressure; Community-dwelling; Traditional Chinese Medicine

Outcome Measures

Primary Outcomes (3)

• The severity of constipation at baseline

  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 will be assessed at baseline assessment.

• The severity of constipation at post-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 will be assessed after 10 days intervention.

• The severity of constipation at 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.

  The severity of constipation will be assessed after one month follow-up.

Secondary Outcomes (9)

• Quality of life at baseline

  Quality of life will be assessed at baseline assessment.

• Quality of life at post-intervention

  Quality of life will be assessed after 10 days intervention.

• Quality of life at one month follow-up

  Quality of life will be assessed after one month follow-up.

• Psychosocial well-being at baseline

  Psychosocial well-being will be assessed at baseline assessment.

• Psychosocial well-being at post-intervention

  Psychosocial well-being will be assessed after 10 days intervention.

Study Arms (2)

Intervention group

EXPERIMENTAL

The intervention group will receive home-based acupressure and nursing education.

Other: Home-based, acupressure combined with nursing education

Control group: Home-based sham group , acupressure combined with nursing interventions

ACTIVE COMPARATOR

The control group will receive home-based, manual light touch of the abdomen combined with nursing education.

Other: Home-based, manual light touch of the abdomen combined with nursing education

Interventions

Home-based, acupressure combined with nursing education OTHER

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.

Intervention group

Home-based, manual light touch of the abdomen combined with nursing education OTHER

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.

Control group: Home-based sham group , acupressure combined with nursing interventions

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• being Hong Kong residents between the ages of 18 or older,
• having an SCI diagnosis for over 6 months and living in the community,
• demonstrating the willingness and ability to learn and engage in acupressure (or having a caregiver to assist if self-operating is not feasible),
• experiencing difficulties with defecation or having concerns related to defecation.

You may not qualify if:

• currently undergoing other TCM treatments or receiving interventions related to defecation or bowel functions,
• being unable to attend the training sessions due to personal reasons,
• having a history of gastrointestinal organic disease,
• having severe metabolic diseases, cardiovascular, cerebrovascular, or mental illnesses

Sponsors & Collaborators

• The Hong Kong Polytechnic University: lead

Study Sites (1)

School of Nursing, The Hong Kong Polytechnic Unviersity

Hong Kong, Hong Kong

Location

Related Publications (36)

• March, I.C.f.C.o.S.C.I.P.J.I., Global summary of spinal cord injury, incidence and economic impact. 2004.

  BACKGROUND

• Qiu J. China Spinal Cord Injury Network: changes from within. Lancet Neurol. 2009 Jul;8(7):606-7. doi: 10.1016/S1474-4422(09)70162-0. No abstract available.

  PMID: 19539234 BACKGROUND

• Zhao JR, Chen W, Zhao N, Zhang H. Q, Zhu. B. Research Progress on Mechanism of Traditional Chinese Medicine in Treatment of Spinal Cord Injury, Chinese Archives of Traditional Chinese Medicine. (2020); 8:1-14.

  BACKGROUND

• Zhong C, Li YM. Overview of Chinese Medicine and Experimental Profiles on Spinal Cord Injury, Journal of Hunan University of Chinese Medicine. 2015; 35(10): 66-69.

  BACKGROUND

• Sun Y, Zhan D, Tan MS, Discuss treating the Spinal Cord injury from the dredge of the Governor Vessel Chinese Journal of Traditional Medical Traumatology & Orthopedics. 2018; (2): 64-66.

  BACKGROUND

• Sun Y. Study on the correlation between surgical treatment of atlantoaxial dislocation and nourishing qi and yang, Beijing University of Chinese Medicine. 2019.

  BACKGROUND

• Xu W, Hao M. Clinical study on abdominal Eight Diagrams Manipulation Maneuver combined with nursing intervention in the treatment of constipation in patients with spinal cord injury, China Health Industry. 2013; 10(26): 190-191.

  BACKGROUND

• Wong WK, Chien WT, Lee WM. Self-administered acupressure for treating adult psychiatric patients with constipation: a randomized controlled trial. Chin Med. 2015 Nov 3;10:32. doi: 10.1186/s13020-015-0064-7. eCollection 2015.

  PMID: 26535053 BACKGROUND

• Liao CH, Xie ZL. Experience of traditional Chinese medicine nursing intervention on preventing constipation in bedridden patients with spinal cord injury experience, Chinese Community Doctors. 2012; 14(23): 299-300.

  BACKGROUND

• Su SY, Qian R, Wei SH. Clinical observation of acupoint sticking in the treatment of constipation due to spleen deficiency and qi stagnation, Nei Mongol Journal of Traditional Chinese Medicine. 2018; 37(6): 96-97.

  BACKGROUND

• Bengtsson M, Ohlsson B. Psychological well-being and symptoms in women with chronic constipation treated with sodium picosulphate. Gastroenterol Nurs. 2005 Jan-Feb;28(1):3-12. doi: 10.1097/00001610-200501000-00002.

  PMID: 15738724 BACKGROUND

• De Giorgio R, Ruggeri E, Stanghellini V, Eusebi LH, Bazzoli F, Chiarioni G. Chronic constipation in the elderly: a primer for the gastroenterologist. BMC Gastroenterol. 2015 Oct 14;15:130. doi: 10.1186/s12876-015-0366-3.

  PMID: 26467668 BACKGROUND

• Li HM, Gao JH. Clinical study of raw potato juice combined with abdominal Bagua massage in the treatment of spinal cord injury and constipation, Nei Mongol Journal of Traditional Chinese Medicine. 2014; 33(13): 37-38.

  BACKGROUND

• Zhang D, Xia ZW. Rome III criteria for functional constipation, Chinese Journal of Medicine. 2008; 43(12): 63-64.

  BACKGROUND

• Chang HC et al., Study on the effect of acupressure on constipation in nursing home residents, Journal of Yuanpei University. 2010; (17): 53-64.

  BACKGROUND

• Chen YF. Effectiveness of the applying of acupressure and abdominal massage to improve constipation in stroke patients. 2017;1-146.

  BACKGROUND

• Wang XD, Cai JP, Zhang YL. Effects of Xiao Zhang San on Umbilical Area Combined with the Acupoints Acupressure on Constipation, Nursing Journal of Chinese People's Liberation Army. 2013; 30(16).

  BACKGROUND

• Chao ML, Chen LJ. Effects of Acupressure at Relieving Constipation in Persistent Vegetative State: A Randomized Controlled Trial, Journal of Integrated Chinese and Western Medicine. 2010; 12(2):11-20.

  BACKGROUND

• Wang HP, et al., The effectiveness of Acupressure on Stroke Patents with Constipation, Chang Gung Nursing. 2006;17(4): 418-427.

  BACKGROUND

• Xin LF, Pan YL. Effect of acupoint massage on preventing constipation in patients with cerebral hemorrhage, Chinese Journal of Modern Nursing. 2012; 18(22): 2699-2700.

  BACKGROUND

• Chen XL, Wang YP. 50 cases of Acupoint massage of constipation in patients with senile dementia, Zhejiang Journal of Traditional Chinese Medicine. 2009; 44(2): 138-138.

  BACKGROUND

• Lin SF, et al., Effectiveness of Acupressure on Elderly Patients with Constipation, Journal of Nursing and Healthcare Research. 2011; 7(3):175-187.

  BACKGROUND

• Liao WF, Zhang H. Brief discussion on Tianshu Point, World Health Digest Medical Monthly. 2007; (4): p.139.

  BACKGROUND

• Qin HB, Nan WZ, Yang M. General situation of clinical application of Zhongwan point, Hunan Journal of Traditional Chinese Medicine. 2018; 34(9): 214-216.

  BACKGROUND

• Cheung DST, Tiwari A, Yeung WF, Yu DSF, So MKP, Chau PH, Wang XM, Lum TYS, Yuk Fung HYK, Ng BYM, Zhang ZJ, Lao L. Self-Administered Acupressure for Caregivers of Older Family Members: A Randomized Controlled Trial. J Am Geriatr Soc. 2020 Jun;68(6):1193-1201. doi: 10.1111/jgs.16357. Epub 2020 Feb 25.

  PMID: 32096884 BACKGROUND

• Yeung WF, Ho FY, Chung KF, Zhang ZJ, Yu BY, Suen LK, Chan LY, Chen HY, Ho LM, Lao LX. Self-administered acupressure for insomnia disorder: a pilot randomized controlled trial. J Sleep Res. 2018 Apr;27(2):220-231. doi: 10.1111/jsr.12597. Epub 2017 Sep 8.

  PMID: 28884877 BACKGROUND

• Chen YT, Chang YM, Bai CH. The Effectiveness of Acupressure at Relieving Constipation in Neurological Patients, Evidence Based Nursing. 2006; 2(4):301-310.

  BACKGROUND

• Zhou RW, Traditional Chinese Medicine diagnosis of the Functional Constipation, Beijing Journal of Traditional Chinese Medicine. 2009; 28(2):115-116.

  BACKGROUND

• Chen Z, et al., Clinical Study on Acupuncture at Jiaji Point for Spinal Cord Injury Constipation, Journal of Liaoning University of Traditional Chinese Medicine. 2014; 16(1): 189-190.

  BACKGROUND

• McMillan SC, Williams FA. Validity and reliability of the Constipation Assessment Scale. Cancer Nurs. 1989 Jun;12(3):183-8. doi: 10.1097/00002820-198906000-00012.

  PMID: 2743302 BACKGROUND

• Marquis P, De La Loge C, Dubois D, McDermott A, Chassany O. Development and validation of the Patient Assessment of Constipation Quality of Life questionnaire. Scand J Gastroenterol. 2005 May;40(5):540-51. doi: 10.1080/00365520510012208.

  PMID: 16036506 BACKGROUND

• Li Y, Bressington D, Chien WT. Pilot evaluation of a coping-oriented supportive program for people with spinal cord injury during inpatient rehabilitation. Disabil Rehabil. 2019 Jan;41(2):182-190. doi: 10.1080/09638288.2017.1386238. Epub 2017 Oct 10.

  PMID: 28994618 BACKGROUND

• Li Y, Chien WT, Bressington D. Effects of a coping-oriented supportive programme for people with spinal cord injury during inpatient rehabilitation: a quasi-experimental study. Spinal Cord. 2020 Jan;58(1):58-69. doi: 10.1038/s41393-019-0320-2. Epub 2019 Jun 28.

  PMID: 31253849 BACKGROUND

• Kwan RYC, Leung MCP, Lai CKY. A Randomized Controlled Trial Examining the Effect of Acupressure on Agitation and Salivary Cortisol in Nursing Home Residents with Dementia. Dement Geriatr Cogn Disord. 2017;44(1-2):92-104. doi: 10.1159/000478739. Epub 2017 Jul 29.

  PMID: 28768251 BACKGROUND

• Chung KF, Yeung WF, Yu BY, Leung FC, Zhang SP, Zhang ZJ, Ng RM, Yiu GC. Acupuncture with or without combined auricular acupuncture for insomnia: a randomised, waitlist-controlled trial. Acupunct Med. 2018 Feb;36(1):2-13. doi: 10.1136/acupmed-2017-011371. Epub 2017 Dec 11.

  PMID: 29229613 BACKGROUND

• Li MQ, Li Y, Lam W, Yeung WF, Ho YS, Li JY, Sun TC, Yuen S, Hu YL, Yorke J. Home-based acupressure for managing constipation and subjective well-being in spinal cord injury survivors: A randomized controlled trial. J Integr Med. 2025 Nov;23(6):660-669. doi: 10.1016/j.joim.2025.08.001. Epub 2025 Aug 7.

  PMID: 40846520 DERIVED

MeSH Terms

Conditions

Spinal Cord Injuries

Condition Hierarchy (Ancestors)

Spinal Cord Diseases; Central Nervous System Diseases; Nervous System Diseases; Trauma, Nervous System; Wounds and Injuries

Study Officials

• Yan Li, Dr

  School of Nursing, The Hong Kong Polytechnic University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: 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

Study Record Dates

• First Submitted: September 6, 2022
• First Posted: September 28, 2022
• Study Start: March 1, 2023
• Primary Completion: September 30, 2024
• Study Completion: September 30, 2024
• Last Updated: October 10, 2024

Record last verified: 2024-09

Locations

HK (1)