22. European Stroke Conference 832 Rehabilitation and reorganisation after stroke Comparing the Effects of Acupressure and Abdominal Massage for the Alleviation of Consti-pation Symptoms in People with Stroke: a randomized controlled study J.W. Hung1, H.H. Chiu2, K.C. Chang3, C.H. Chou4, S.F. Lin5 Department of Physical Medicine and Rehabilitation,Kaohsiung Chang Gung Memorial Hos-pital, Taiwan, Kaohsiung, TAIWAN1, Division of Acupuncture and Chinese Traumatology,Kaoh-siung Chang Gung Memorial Hospital, Taiwan, Kaohsiung, TAIWAN2, Division of Cerebrovascular Diseases, Kaohsiung Chang Gung Memorial Hospital, Taiwan, Kaohsiung, TAIWAN3, Division of Acupuncture and Chinese Traumatology,Kaohsiung Chang Gung Memorial Hospital, Taiwan, Kaoh-siung, TAIWAN4, Department of Physical Medicine and Rehabilitation,Kaohsiung Chang Gung Me-morial Hospital, Taiwan, Kaohsiung, TAIWAN5 Background: Constipation is the dominant gastrointestinal problem after stroke. In Western Med-icine, abdominal massage is usually recommended as part of an integrated bowel management; in traditional Chinese medicine, acupressure is suggested. Our aim is to compare the efficacy of acu-pressure and abdominal massage for the relief of constipation in people with stroke. Methods: This is a prospective, randomized control study. Stroke patients admitted to inpatient re-habilitation ward are potential eligible. Those who fulfilled the one of the conditions (1) use of lax-atives for constipation, or (2) fulfillment of the modified Rome II Diagnostic Criteria for functional constipation were recruited and randomized to 1) conventional treating 2)abdominal massage or 3) acupressure group. The abdominal massage began at the cecum and extended along the length of the colon to the rectum. Acupressure was done according to the sequence as right ST36, right SP15, CV12, left SP15, CV6, left ST36. Both maneuvers were performed by the primary caregivers, 15 minutes per section, 2 sections per day. During the hospital days around 3 weeks of intervention could be completed. After discharge, participants were encouraged to continue the intervention. The constipation scoring system(CSS) was used as the primary outcome measurement; neurogenic bow-el dysfunction score(NBDS), laxative dose titration status, the subjective opinion of the allocated protocol were as the secondary outcome measurements. The outcome measures were done at Week 0, 3, 7 and 15. Results: One hundred twenty-five participants completed the 3 weeks intervention. The improve-ment in the CSS, NBDS and the decreasing oral laxatives were significant in all groups at week 3, 7 and 15, however, there was no group difference in all outcome measures. Patients preferred oral medication only. Conclusion: The findings appeared that neither abdominal massage nor acupressure could have addi-tional benefit in releasing constipation symptoms. 786 © 2013 S. Karger AG, Basel Scientific Programme 833 Rehabilitation and reorganisation after stroke Health-Related Quality of Life among Stroke Survivors in Kano, Nigeria: a mixed-method study A.M. Hamza1, A.S. Nabilla2, S.Y. Loh35 Center for Population Health, University of Malaya, Malaysia, Kuala Lumpur, MALAYSIA1, Center for Population Health, University of Malaya, Malaysia, Kuala Lumpur, MALAYSIA2, De-partment of Rehabilitation medicine, University of Malaya, Malaysia, Kuala Lumpur, MALAYSIA3 Introduction : This study aims to determine the factors influencing the quality of life of stroke sur-vivors and to illuminate why and how these individuals retain or lose their sense of wellbeing after stroke amongst the rising number of stroke survivors in Kano, Nigeria – a timely public health bur-den. Method: This is a mixed method study conducted in 3 phases on stroke survivors (n=233) in Kano, Nigeria. Phase I involved the validation of the primary tools for the measurement of QOL and social support. Phase II (quantitative phase) is a longitudinal survey to identify the patterns and predictors of QOL at 6 months and 1 year after stroke. The final Phase III is a qualitative design to explore the reasons for the observed patterns from the earlier phase. Results: Psychometrically the 16-item Hausa version of the Stroke Impact Scale (Hausa-SIS) and the 11-item Hausa version of the Multidimensional Scale of Perceived Social Support (Hau-sa- MSPSS) are valid for the assessment of QOL and perceived social support among stroke survi-vors in Nigeria.The eight dimensions of QOL, excluding the emotional domain, showed significant improvement at 1 year after stroke. However, social support was significantly decreased from 6 months to 1 year after stroke. Conclusion: Using multiple linear regressions, the determinants of satisfactory QOL at 6 months af-ter stroke were: occupation before stroke, occupation after stroke, income, caregiver, effect to work, education, side of stroke, BI score, residency, MRS score and overall social support. For determi-nants of satisfactory QOL at 6 months after stroke, hospital treatment charges and perceived social support by friends were found as key determinant to satisfactory QOL at 1 year after stroke. the de-terminants of unsatisfactory QOL at 6 months after stroke were: age, occupation after stroke, hospi-tal treatment charges, MRS score, BDI score, and side of stroke.
Karger_ESC London_2013
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