The Effects of Rocking Chair Motion on Postoperative Ileus Duration, Subjective Pain and Time to Discharge Following Abdominal Surgery
Ileus is a lack of bowel function that can cause colic, vomiting, and/or constipation.
Research has shown that bowel function slows down and possibly stops working for a short
period of time after surgery, usually for 5-7 days. Patients report pain and discomfort
from the gas that builds up in their bowel until the time the bowel begins working properly
after surgery. During the period the bowel is not working after surgery, patients cannot
leave the hospital until their physician is sure that their bowel function has returned.
The return in bowel function is usually signaled by the passage of gas from the rectum.
The main method used to help the return of bowel function is to have patients get out of
bed, sit in a chair, and begin walking the first day after surgery and increase the time
sitting in the chair and walking every day. However, it is not clear that the sitting in a
chair and walking are the best methods to assist in a faster return of bowel function.
One method that shows promise in helping the return of bowel function after abdominal
surgery is rocking in a rocking chair. Rocking chair motion has demonstrated an earlier
return of normal bowel function in mothers after C-Section and women after abdominal
hysterectomy (Moore et al.,1995; Thomas et al., 1990). Rocking also has been used to
decrease pain, the amount of pain medication needed, and the time spent in the hospital
after abdominal surgery.
If you agree to take part in this study, you will be randomly assigned to one of two groups
(Group A or B). Participants in Group A will use the rocking chair method. Participants in
Group B will not use the rocking chair method. There is an equal chance of being assigned
to either group.
Before you take part in this study, you will be asked to complete a survey about the amount
of pain you are currently experiencing (the Brief Pain Inventory-Short Form). It should
take about 10 minutes to complete the Brief Pain Inventory-Short Form. Completing the pain
inventory before your surgery will allow for a better comparison of your pre and
postoperative surgical and gas pain. You will be asked to provide some information such as
your age and marital status that will be recorded on a coded data sheet. You will also
receive an instruction sheet that describes what you need to do in order to participate in
the study (Instruction to Subjects Sheet). The study investigator will also demonstrate to
those chosen for the rocking group the correct method to rock in the rocking chair and allow
them time to practice. He will also demonstrate the correct way to wear the gait belt with
the pedometer attached to it.
Participants in Group A will get out of bed beginning the first day after surgery, sit in a
rocking chair (at least twice per day), and rock backward and forward at a constant rate of
1 backward and forward rock per second in 10-20 minute increments. This will be done for at
least 60 minutes (1 hour) per day. Participants in Group A will also be asked to begin
walking at least twice per day beginning the first day after surgery.
Participants in Group B will get out of bed beginning the first day after surgery and sit in
a non rocking chair (at least twice per day) for at least sixty minutes. Group B will also
be asked to begin walking at least twice per day.
Both groups will wear a pedometer attached to a gait belt worn around their waist in order
to record the number of steps taken in a 24-hour period of time. A pedometer will also be
attached to each rocking chair in order to record the number of rocks in a 24-hour period.
Participants in each group will be encouraged by the research staff to increase the time
spent rocking, sitting in the non-rocking chair, and walking each day. You will be given
pain medication as needed.
All participants will be given a pencil and pad to note the date and time that they first
pass gas from their rectum. A calendar and clock is available in all patient rooms. Every
morning, the study investigator will visit you and ask if you have passed gas, record the
number of rocks and steps recorded by the pedometers, reset the pedometers, have you
complete a Brief Pain Inventory-Short Form pain evaluation, and check on the total amount of
pain medication you have received over the last 24 hours. You may increase the time spent
rocking and walking as you desire and are encouraged to do so.
If for any reason, you cannot tolerate rocking in a rocking chair, sitting in a non rocking
chair or walking because of discomfort or any other reason, you will be removed from the
study without penalty.
There is no follow-up testing for this study. The length of this study is from the first
day after your surgery until you actually pass gas from the rectum. This time could range
from 5 to 7 days after your operation.
This is an investigational study. There are no drugs involved with this study. Rocking, non
rocking chairs, and gait belts will be provided by M. D. Anderson and the pedometers by the
study investigator at no charge to the participants during the study. A total of 66
patients will take part in this study. All will be enrolled at M. D. Anderson.
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Caregiver), Primary Purpose: Treatment
Time to First Postoperative Flatus in Days Was the End of Postoperative Ileus (POI) Indicator.
Time from end of surgical procedure until passage of first postoperative flatus was used as an indicator for resolution of postoperatve ileus (POI).
Daily from first day after surgical procedure to passage of first flatus (up to 5 - 7 days post surgery).
Robert L. Massey, RN
M.D. Anderson Cancer Center
United States: Institutional Review Board
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