INITIAL EVALUATION OF THE EFFECTIVENESS OF COMBINED PHYSICAL THERAPY IN THE TREATMENT OF CONSTIPATION IN STROKE PATIENTS AT THE DEPARTMENT OF PHYSICAL THERAPY, 108 CENTRAL MILITARY HOSPITAL, IN 2025

Tran Hong Phuong1, Do Thi Tuyet1, Pham Thi Chau Loan1, Le Thi Thom1, Le Thi Nguyet1, Nguyen Dang Nam1, Tran Thi Thanh Thao1
1 Rehabilitation Center, 108th Military Hospital

Main Article Content

Abstract

Objective: To evaluate the effectiveness of physical therapy in treating constipation in stroke patients at the Rehabilitation Department, 108 Military Central Hospital.Materials and Methods: A prospective, non-controlled clinical intervention study was conducted on 32 stroke patients with constipation symptoms, treated at the Rehabilitation Department, 108 Military Central Hospital from December 2024 to May 2025. Patients received: abdominal massage, pelvic floor and abdominal muscle strengthening exercises, and electrical stimulation of the pelvic floor muscles Results: Among constipated patients, 68.75% had ischemic stroke and 21.25% had hemorrhagic stroke. After intervention, defecation frequency increased from 2.1 ± 0.7 to 4.8 ± 0.9 times/week (p<0.001), defecation time decreased from 15.3 ± 5.2 to 7.4 ± 2.6 minutes (p<0.001), and the Bristol score improved from 1.8 ± 0.8 to 3.7 ± 0.7 (p<0.001). Quality of life measured by SF-36 significantly increased from 42.9 ± 13.9 to 60.5 ± 11.6 points (p<0.001), with improvements across all 8 domains. The majority of patients (84.4%) were satisfied with the intervention outcomes.Conclusion: Physical therapy is an effective method for treating constipation in stroke patients, significantly improving defecation frequency and quality, while enhancing patients' overall quality of life.

Article Details

References

[1] J. Li, M. Yuan, Y. Liu, Y. Zhao, J. Wang, and W. Guo, ‘Incidence of constipation in stroke patients’, Medicine (Baltimore), vol. 96, no. 25, p. e7225, Jun. 2017, doi: 10.1097/MD.0000000000007225.
[2] Y. Su et al., ‘New-Onset Constipation at Acute Stage After First Stroke’, Stroke, vol. 40, no. 4, pp. 1304–1309, Apr. 2009, doi: 10.1161/STROKEAHA.108.534776.
[3] Camara-Lemarroy, C. R., Ibarra-Yruegas, B. E., & Gongora-Rivera, F. (2014). Gastrointestinal complications after ischemic stroke. Journal of the neurological sciences, 346(1-2), 20–25. https://doi.org/10.1016/j.jns.2014.08.027

[4] Du, W., Yang, S., Zhou, H., Wu, Y., Cai, Y., Meng, H., Teng, H., & He, A. F. (2023). The association between constipation and stroke based on the NHANES and Mendelian randomization study. Frontiers in neuroscience, 17, 1276032. https://doi.org/10.3389/fnins.2023.1276032

[5] K. L. Harrington and E. M. Haskvitz, ‘Managing a Patient’s Constipation With Physical Therapy’, Phys. Ther., vol. 86, no. 11, pp. 1511–1519, Nov. 2006, doi: 10.2522/ptj.20050347.
[6] X. Zhao, L. Liu, Y. Diao, and C. Ma, ‘Effectiveness of abdominal electroacupuncture therapy for poststroke constipation: a meta-analysis’, Front. Neurol., vol. 15, p. 1480681, Nov. 2024, doi: 10.3389/fneur.2024.1480681.
[7] Nguyễn, T. H. (2024). THỰC TRẠNG TÁO BÓN TRÊN BỆNH NHÂN ĐỘT QUỴ NÃO. Tạp Chí Y học Việt Nam, 539(1).
[8] Bracci, F., Badiali, D., Pezzotti, P., Scivoletto, G., Fuoco, U., Di Lucente, L., Petrelli, A., & Corazziari, E. (2007). Chronic constipation in hemiplegic patients. World journal of gastroenterology, 13(29), 3967–3972. https://doi.org/10.3748/wjg.v13.i29.3967
[9] GBD 2019 Stroke Collaborators (2021). Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. Neurology, 20(10), 795–820. https://doi.org/10.1016/S1474-4422(21)00252-0
[10] Auger, L. P., Filiatrault, J., Allegue, D. R., Vachon, B., Thomas, A., Morales, E., & Rochette, A. (2023). Sexual Rehabilitation After a Stroke: A Multi-site Qualitative Study About Influencing Factors and Strategies to Improve Services. Sexuality and disability, 1–27. Advance online publication. https://doi.org/10.1007/s11195-023-09795-x
[11] Wang, Q. S., Liu, Y., Zou, X. N., Ma, Y. L., & Liu, G. L. (2020). Evaluating the Efficacy of Massage Intervention for the Treatment of Poststroke Constipation: A Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM, 2020, 8934751. https://doi.org/10.1155/2020/8934751

[12] Lim, S. F., Ong, S. Y., Tan, Y. L., Ng, Y. S., Chan, Y. H., & Childs, C. (2015). Incidence and predictors of new-onset constipation during acute hospitalisation after stroke. International journal of clinical practice, 69(4), 422–428. https://doi.org/10.1111/ijcp.12528