The Effect of Abdominal Massage and In-Bed Exercise on Gastrointestinal Complications, Pain and Comfort in Palliative Care Patients: A Randomised Controlled Trial.

Patients and researchers could not be blinded, and the main comfort and pain outcomes relied on observation and a faces scale. The follow-up lasted only three days, so it cannot show whether effects persisted. Abdominal distension was assessed by palpation and behaviour rather than objective measurement, which may have affected accuracy. Prokinetic medications and individualised enteral nutrition formulas were not recorded or standardised, so they may have influenced gastrointestinal outcomes. Gastric residual volume, nutrition amount and caloric intake were not measured, so feeding tolerance cannot be fully checked. Functional and mobility status was not measured with standard tools, so patients may not have been fully comparable for exercise capacity.

No specific funding was reported. The authors stated that they performed the statistical analyses themselves.

Do not conclude that abdominal massage or in-bed exercise alone caused the improvements. Patients also received enteral nutrition, routine prescribed medical treatments, and prokinetic agents when clinically indicated, and those medications were not recorded or analysed. The gastrointestinal symptom results were also inconsistent.