Effect of home-based acupressure on constipation in people with spinal cord injury: A study protocol for a randomized controlled trial with a mixed-method approach

Introduction: People with spinal cord injuries often experience constipation. Common surgical and conservative treatments for constipation may have long-term adverse events that outweigh their benefits in relieving symptoms temporarily. This proposed study aims to investigate the effects of acupressure on constipation, quality of life, psychosocial well-being, and bowel habits in a community-based spinal cord injury population.

Methods: This two-parallel-group, open-label controlled trial will randomly assign 78 eligible participants to the intervention or control groups. After receiving defecation education, the intervention group will perform 10-days of self-operated or caregiver-assisted acupressure manually, while the control group will conduct a manual light touch on the abdomen. The study will assess participants' constipation severity as the primary outcome, along with secondary outcomes including quality of life, psychosocial well-being, bowel habits, and participants’ perceptions of acupressure. Participants' perceptions of acupressure will be assessed through semi-structured focus group interviews after intervention. Other measurements will be taken at baseline, immediately post-intervention, and at a 1-month follow-up. The generalized estimating equations and content analysis will be employed to analyze the intervention effect and interview data, respectively.

Discussion: This study will be the first to evaluate the effect of applying acupressure in people with spinal cord injuries to improve their constipation. The intervention may offer an alternate, non-invasive therapy option for individuals with spinal cord injuries who live in the community.