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Published on: July 6, 2017
Tongue-Rotation Exercise Performance Recovers Intestinal Function After Cesarean Delivery: A Prospective Randomized
Shunsuke Hyuga1, Miho Shishii, Yoshiko Osada
1Author Affiliations: Division of Obstetric Anesthesia, Center for Perinatal Care, Child Health and Development, Kitasato University Hospital, Sagamihara City, Kanagawa, Japan (Dr Hyuga, Dr Shishii, Dr Kondo, Dr Fujita, and Dr Okutomi); and Department of Anesthesiology, Kitasato University, School of Medicine, Sagamihara City, Kanagawa, Japan (Dr Hyuga, Dr Shishii, Dr Osada, Dr Kondo, Dr Fujita, and Dr Okutomi).
Purpose:
To investigate whether tongue-rotation exercises promote the recovery of bowel function after cesarean section.
Background:
Intestinal dysfunction after cesarean section is a serious complication. Chewing gum mastication is considered to promote the recovery of intestinal function after cesarean section. This effect is attributed to increased secretion of digestive hormones when chewing. A similar effect can be achieved with tongue-rotation exercise. However, whether this technique is effective for postoperative intestinal dysfunction remains unclear.
Methods:
This prospective, randomized, open-label trial enrolled women scheduled for elective cesarean section at our hospital (September 2022-March 2023). Participants were randomized to group C (usual postoperative fasting: no drinking for 2 hours and no eating for 6 hours) or group T (usual care plus tongue-rotation exercises 3 times daily from 2 hours postoperatively until first flatus). The primary end point was time to first flatus. Secondary end points included time to first bowel sounds/peristalsis, time to first bowel movement, length of stay, nausea/vomiting, ileus, abdominal distention, and salivary amylase activity before and after the exercise.
Results:
Sixty participants (30 per group) were analyzed, with no differences in baseline characteristics. Time to first flatus was significantly shorter in group T than in group C (927 ± 326 vs 1,233 ± 683 min; P = .031). No significant differences were observed in secondary end points.
Conclusions:
Tongue-rotation exercises may contribute to early recovery after cesarean section by improving bowel function, thereby facilitating postpartum childcare.
Implications For Practice And Research:
Practice: Tongue-rotation exercises may be a feasible, no-cost adjunct to standard postcesarean care to facilitate earlier return of bowel function when gum chewing is undesirable. Research: Larger trials comparing tongue rotation with chewing gum and evaluating patient-centered outcomes (comfort, feeding, breastfeeding, satisfaction) are warranted.
Trial Registration:
UMIN-CTR UMIN000055628; registered 2024-09-26; retrospectively registered.
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