Abdominal massage for neurogenic bowel dysfunction in people with multiple sclerosis (AMBER - Abdominal Massage for Bowel Dysfunction Effectiveness Research)- study protocol for a randomised controlled trial

Doreen McClurg (Corresponding Author), Kirsteen Goodman , Suzanne Hagen, Fional Harris, Shaun Treweek, Anton Emmanuel, Christine Norton, Maureen Coggrave, Selina Doran, John Norrie, Peter Donnan, Helen Mason, Sarkis Manoukian

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)
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Abstract

Background
Multiple sclerosis (MS) is a life-long condition primarily affecting younger adults. Neurogenic bowel dysfunction (NBD) occurs in 50–80% of these patients and is the term used to describe constipation and faecal incontinence, which often co-exist. Data from a pilot study suggested feasibility of using abdominal massage for the relief of constipation, but the effectiveness remains uncertain.

Methods/design
This is a multi-centred patient randomised superiority trial comparing an experimental strategy of once daily abdominal massage for 6 weeks against a control strategy of no massage in people with MS who have stated that their constipation is bothersome. The primary outcome is the Neurogenic Bowel Dysfunction Score at 24 weeks. Both groups will receive optimised advice plus the MS Society booklet on bowel management in MS, and will continue to receive usual care.

Participants and their clinicians will not be blinded to the allocated intervention. Outcome measures are primarily self-reported and submitted anonymously. Central trial staff who will manage and analyse the trial data will be unaware of participant allocations. Analysis will follow intention-to-treat principles.

Discussion
This pragmatic randomised controlled trial will demonstrate if abdominal massage is an effective, cost-effective and viable addition to the treatment of NBD in people with MS.

Trial registration
ClinicalTrials.gov, ISRCTN85007023. Registered on 10 June 2014.
Original languageEnglish
Article number150
JournalTrials
Volume18
DOIs
Publication statusPublished - 29 Mar 2017

Bibliographical note

The trial was funded by the United Kingdom National Health Service through the National Institute for Health Research Health Technology Assessment programme, open call project number HTA 12/127.

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