Treating Small Bowel Obstruction with a Manual Physical Therapy: A Prospective Efficacy Study.

Amanda D Rice,Lawrence J Wurn,C Richard King,Kimberley Patterson,Evette D Reed,Belinda F Wurn,Bernhard Klingenberg

doi:10.1155/2016/7610387

Amanda D Rice, Lawrence J Wurn + Show 5 more

Open Access

https://doi.org/10.1155/2016/7610387

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Abstract

Small bowel obstructions (SBOs) caused by adhesions are a common, often life-threatening postsurgical complication with few treatment options available for patients. This study examines the efficacy of a manual physical therapy treatment regimen on the pain and quality of life of subjects with a history of bowel obstructions due to adhesions in a prospective, controlled survey based study. Changes in six domains of quality of life were measured via ratings reported before and after treatment using the validated Small Bowel Obstruction Questionnaire (SBO-Q). Improvements in the domains for pain (p = 0.0087), overall quality of life (p = 0.0016), and pain severity (p = 0.0006) were significant when average scores before treatment were compared with scores after treatment. The gastrointestinal symptoms (p = 0.0258) domain was marginally significant. There was no statistically significant improvement identified in the diet or medication domains in the SBO-Q for this population. Significant improvements in range of motion in the trunk (p ≤ 0.001), often limited by adhesions, were also observed for all measures. This study demonstrates in a small number of subjects that this manual physical therapy protocol is an effective treatment option for patients with adhesive small bowel obstructions as measured by subject reported symptoms and quality of life.

Highlights

Small bowel obstruction (SBO) is a common life-threatening complication of surgery or abdominal trauma, typically caused by adhesions that form as a normal part of the healing process
We report on the use of the Clear Passage Approach (CPA), a manual physical therapy protocol, to treat abdominal and pelvic adhesions causing SBOs and improve the quality of life (QOL) of study subjects
It is widely accepted that the adhesions that cause SBO and symptomology in subjects are typically caused from prior abdominal or pelvic surgery [4, 38]

Summary

Introduction

Small bowel obstruction (SBO) is a common life-threatening complication of surgery or abdominal trauma, typically caused by adhesions that form as a normal part of the healing process. A large previously published clinical study followed adult patients 10 years after surgery and found that more than one-third of the surgical small bowel resection patients underwent additional surgery due to adhesions within the study time frame [6]. The Clear Passage Approach (CPA), a mPT protocol hypothesized to deform the adhesions that cause SBO episodes, has been demonstrated previously in case reports to negate the need for surgery in patients with recurrent SBOs and other adhesion related diseases [27,28,29]. We report on the use of the CPA, a manual physical therapy protocol, to treat abdominal and pelvic adhesions causing SBOs and improve the quality of life (QOL) of study subjects

Patients and Methods

Results

Conclusions

Conflict of Interests