Contributions
Abstract: P360
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Neurogenic bowel dysfunction (NBD) occurs in 50-80% of people with Multiple Sclerosis (PwMS). Causes include decreased mobility, polypharmacy, decreased colonic transit time, poor sensation and altered ano-rectal sphincter tone. There is evidence that despite substantially affecting quality of life, constipation continues to be a symptom often not discussed with clinicians due to embarrassment, lack of knowledge and perception of limited management options.
Advice plus abdominal massage is a potential self-management intervention for the relief of constipation. We report on the results of a randomised controlled trial comparing abdominal massage plus self-help information on bowel management to self-help information (AMBER).
Methods: 191 patients with MS and constipation were recruited from 12 centres across the UK. Those randomised to the intervention group were shown how to do the massage, provided with training materials (e.g. DVD) and information on bowel management; the control group received information only. All participants received weekly support telephone calls during the 6 weeks of intervention. The primary outcome was the Neurogenic Bowel Dysfunction score at Week 24 and secondary outcomes included bowel diary data.
Results: Both groups reported improvement in symptoms with a significant mean difference in frequency of defaecation between the groups at Week 24 (mean change 0.62, 95% CI, 0.03, 2.21, p=0.039) in favour of the massage group. Massage was primarily undertaken by the participant themselves. At 6 weeks 78/87 (89%) were continuing with the massage, 59 (75.6%) were undertaking the massage themselves and 11 (14.1%) required a carer to do the massage (8 did not complete this question) with a mean of 5.4 hours (SD1.75) per week being spent on the massage. At Week 24, 77/87 (88%) participants were still in the study and of these 51 (66.2%) were continuing with the massage with 1 (1.3%) requiring a carer to undertake the massage, spending a mean of 3.2 hours (SD 2.83) per week. Of those continuing 44 (57.1%) felt benefit, 6 (7.8%) did not feel a benefit and one did not respond. Reasons for discontinuation included no perceived benefit 8 (8.4%), 5 (6.5%) found it too difficult, 1 (1.3%) because of carer burden and 12 (14.9%) provided no reason.
Conclusion: Abdominal massage plus information is an intervention that could be part of a self-management bowel care regimen providing superior improvement to information alone for some PwMS.
Disclosure: none
Abstract: P360
Type: Poster
Abstract Category: Clinical aspects of MS - 7 MS symptoms
Neurogenic bowel dysfunction (NBD) occurs in 50-80% of people with Multiple Sclerosis (PwMS). Causes include decreased mobility, polypharmacy, decreased colonic transit time, poor sensation and altered ano-rectal sphincter tone. There is evidence that despite substantially affecting quality of life, constipation continues to be a symptom often not discussed with clinicians due to embarrassment, lack of knowledge and perception of limited management options.
Advice plus abdominal massage is a potential self-management intervention for the relief of constipation. We report on the results of a randomised controlled trial comparing abdominal massage plus self-help information on bowel management to self-help information (AMBER).
Methods: 191 patients with MS and constipation were recruited from 12 centres across the UK. Those randomised to the intervention group were shown how to do the massage, provided with training materials (e.g. DVD) and information on bowel management; the control group received information only. All participants received weekly support telephone calls during the 6 weeks of intervention. The primary outcome was the Neurogenic Bowel Dysfunction score at Week 24 and secondary outcomes included bowel diary data.
Results: Both groups reported improvement in symptoms with a significant mean difference in frequency of defaecation between the groups at Week 24 (mean change 0.62, 95% CI, 0.03, 2.21, p=0.039) in favour of the massage group. Massage was primarily undertaken by the participant themselves. At 6 weeks 78/87 (89%) were continuing with the massage, 59 (75.6%) were undertaking the massage themselves and 11 (14.1%) required a carer to do the massage (8 did not complete this question) with a mean of 5.4 hours (SD1.75) per week being spent on the massage. At Week 24, 77/87 (88%) participants were still in the study and of these 51 (66.2%) were continuing with the massage with 1 (1.3%) requiring a carer to undertake the massage, spending a mean of 3.2 hours (SD 2.83) per week. Of those continuing 44 (57.1%) felt benefit, 6 (7.8%) did not feel a benefit and one did not respond. Reasons for discontinuation included no perceived benefit 8 (8.4%), 5 (6.5%) found it too difficult, 1 (1.3%) because of carer burden and 12 (14.9%) provided no reason.
Conclusion: Abdominal massage plus information is an intervention that could be part of a self-management bowel care regimen providing superior improvement to information alone for some PwMS.
Disclosure: none