장 기능 향상을 위한 복부?골반저 재활 프로그램이 기능성 변비가 있는 뇌졸중 환자의 배변 형태, 변비 증상, 삶의 질에 미치는 영향

다국어 초록 (Multilingual Abstract)

The purpose of this study was to evaluate the effects of an abdominopelvic rehabilitation program for improving bowel function—consisting of bowel habit education, abdominal massage, diaphragmatic breathing, and abdominopelvic coordination exercises—on stool form, constipation symptoms, and constipation-related quality of life in stroke patients with functional constipation.
Methods: A single-center, single-blind (assessor-blinded) randomized controlled trial was conducted with 32 inpatients with stroke and functional constipation. Participants were randomly allocated in a 1:1 ratio to an experimental group (n=16) or a control group (n=16) using a web-based randomization program. Eligibility for functional constipation required meeting the modified Rome IV questionnaire criteria and a Constipation Assessment Scale score ≥ 5. The experimental group received a 30-minute abdominopelvic rehabilitation program twice weekly for 6 weeks (12 sessions), whereas the control group received 10 minutes of abdominal massage and 20 minutes of conventional neurodevelopmental treatment on the same schedule. Stool form, constipation symptoms, and constipation-related quality of life were assessed before and after the intervention using the Bristol Stool Form Scale (BSFS), Colorectal–Anal Distress Inventory-8 (CRADI-8), and Patient Assessment of Constipation–Quality of Life (PAC-QOL), respectively. One participant in the control group withdrew during the intervention; therefore, 31 participants were included in the final analysis (experimental n=16; control n=15).
Results: BSFS scores shifted toward more normal stool forms in both groups, with no significant between-group difference in the distribution of change. CRADI-8 and PAC-QOL scores decreased significantly after the intervention in both groups, with significantly greater improvements observed in the experimental group compared with the control group (CRADI-8: p<.001; PAC-QOL: p =.014).
Conclusion: The abdominopelvic rehabilitation program for improving bowel function was associated with improvements in constipation symptoms and constipation-related quality of life in stroke patients with functional constipation. Because the program can be delivered within a 30-minute session and easily integrated into routine neurorehabilitation, it may serve as a practical non-pharmacologic intervention for bowel management in stroke rehabilitation settings.

목차 (Table of Contents)

• 목 차 ⅰ
• 표 목 차 ⅲ
• 그림목차 ⅳ
• Ⅰ. 서 론 1
• Ⅱ. 연구 방법 5
• 1. 연구대상자 5
• 2. 연구 설계 및 절차 7
• 3. 중재 방법 9
• 1) 실험군 10
• (1) 배변 교육 10
• (2) 복부 마사지 11
• ① 복부 쓰다듬기 12
• ② I LOVE U 복부 마사지 14
• ③ 회맹판 마사지 16
• ④ 에스결장 스쿱 마사지 18
• (3) 횡격막 호흡 운동 20
• (4) 복부–골반저 협응 운동 22
• ① 골반저 수축–이완 운동 22
• ② 골반저 브릿지 운동 24
• ③ 복부–골반 트위스트 운동 26
• 2) 대조군 28
• 4. 평가 방법 29
• 1) 대변 형태 평가 30
• 2) 골반저 관련 배변곤란 평가 32
• 3) 변비 관련 삶의 질 평가 34
• 5. 분석 방법 36
• Ⅲ. 연구 결과 37
• 1. 연구대상자의 일반적 특성 37
• 2. BSFS 결과 비교 39
• 3. CRADI-8 결과 비교 41
• 4. PAC-QOL 결과 비교 43
• Ⅳ. 고 찰 45
• Ⅴ. 결 론 49
• 참 고 문 헌 50
• 영 문 초 록 55
• 감 사 의 글 58