Decreasing recurrent bowel obstructions,improving quality of life with physiotherapy:Controlled study

作     者：Amanda D Rice Kimberley Patterson Evette D Reed Belinda F Wurn Kristen Robles Bernhard Klingenberg Leonard B Weinstock Janey SA Pratt C Richard King III Lawrence J Wurn 

作者机构：Department of Internal MedicineCollege of Medicine-PhoenixUniversity of ArizonaPhoenixAZ 85004United States Clear Passage TherapiesGainesvilleFL 32606United States Department of Mathematics and StatisticsWilliams CollegeWilliamstownMA 01267United States Clinical Medicine and SurgeryWashington University School of MedicineSpecialists in GastroenterologyLLCSt.LouisMO 63141United States Department of SurgeryStanford University School of MedicinePalo AltoCA 94035United States College of MedicineUniversity of FloridaGainesvilleFL 32607United States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2018年第24卷第19期

页      面：2108-2119页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Clear passage approach Manual therapy Physical therapy Small bowel obstructions Adhesions Physiotherapy Alternative therapy 

摘      要：AIM To compare(1) quality of life and(2) rate of recurrent small bowel obstructions(SBO) for patients treated with novel manual physiotherapy vs no treatment. METHODS One hundred and three subjects(age 19-89) with a history of recurrent adhesive SBO were treated with a manual physiotherapy called the Clear Passage Approach(CPA) which focused on decreasing adhesive crosslinking in abdominopelvic viscera. Pre-and post-therapy data measured recurring obstructions and quality of life, using a validated test sent 90 d after therapy. Results were compared to 136 untreated control subjects who underwent the same measurements for subjects who did not receive any therapy, which is the normal course for patients with recurring SBO. Comparison of the groups allowed us to assess changes when the physiotherapy was added as an adjunct treatment for patients with recurring *** Despite histories of more prior hospitalizations, obstructions, surgeries, and years impacted by bowel issues, the 103 CPA-treated subjects reported a significantly lower rate of repeat SBO than 136 untreated controls(total obstructions P = 0.0003; partial obstructions P = 0.0076). Subjects treated with the therapy demonstrated significant improvements in five of six total domains in the validated Small Bowel Obstruction Questionnaire(SBO-Q). Domains of diet, pain, gastrointestinal symptoms, quality of life(QOL) and pain severity when compared to post CPA treatment were significantly improved(P 0.0001). The medication domain was not changed in the CPA treated group(P = 0.176).CONCLUSION CPA physical therapy was effective for patients with adhesive SBO with significantly lower recurrence rate, improvement in reported symptoms and overall quality of life of subjects.