{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T18:08:57Z","timestamp":1788372537084,"version":"build-2803163510"},"reference-count":47,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T00:00:00Z","timestamp":1690934400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Chemotherapy, as well as opioid and antiemetic drugs, can contribute to constipation in oncological patients. This systematic review aims to analyse the potential of specific rehabilitation strategies and alternative strategies for improving constipation symptoms, with the goal of incorporating these strategies into a dedicated protocol for managing cancer-related constipation. This could potentially reduce the dosages of or eliminate the need for constipation medications. Methods: A systematic search was conducted on PubMed, Scopus and Web of Science. The review included studies analysing constipation complaints in cancer patients treated with rehabilitation, acupuncture and osteopathy. Results: The review included 16 studies in line with PRISMA and PICOS criteria. Most studies showed that physical exercise, abdominal massage, TENS, acupuncture and education on the correct defecation position positively impacted the management of constipation and quality of life in oncological patients. A physiotherapy program involving massages as well as aerobic and resistance training improved constipation in oncological women, regardless of age, sex and frailty. A combination of abdominal massage, abdominal muscle stretching and education on proper defecation position alleviated the severity of constipation and related depression. However, the outcomes regarding TENS were yet inconsistent. Another technique, becoming increasingly common for constipation, and demonstrating positive results, involved stimulating trigger points through acupressure and acupuncture. Conversely, osteopathic and superficial manipulations more frequently required constipation medications than did the other alternative approaches. However, no existing studies have proposed a specific protocol to manage cancer-related constipation. Conclusions: The results of the studies confirm the positive influences of rehabilitation, osteopathy and acupuncture on constipation and pain in oncological patients. Nevertheless, further studies are required to establish the best type, timing and duration of treatment, as well as how the stage and location of the cancer and the cause of constipation (drug-induced or functional) impact the results.<\/jats:p>","DOI":"10.3390\/jcm12155083","type":"journal-article","created":{"date-parts":[[2023,8,2]],"date-time":"2023-08-02T11:17:17Z","timestamp":1690975037000},"page":"5083","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The Role of Rehabilitation in the Treatment of Constipation in Oncological Patients"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1256-7605","authenticated-orcid":false,"given":"Rita","family":"Chiaramonte","sequence":"first","affiliation":[{"name":"Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Bonfiglio","sequence":"additional","affiliation":[{"name":"Provincial Health Department of Siracusa, 96014 Sicily, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Caramma","sequence":"additional","affiliation":[{"name":"Department of Pain Management, Policlinico-San Marco Hospital, 95123 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosaria","family":"Condorelli","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, EOC\u2014Istituto Oncologico della Svizzera Italiana, 6500 Bellinzona, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,8,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1007\/s00520-006-0040-y","article-title":"Cancer chemotherapy-induced diarrhoea and constipation: Mechanisms of damage and prevention strategies","volume":"14","author":"Gibson","year":"2006","journal-title":"Support Care Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1257","DOI":"10.1053\/j.gastro.2016.03.035","article-title":"Rome IV-Functional GI Disorders: Disorders of Gut-Brain Interaction","volume":"150","author":"Drossman","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1191\/0269216303pm760oa","article-title":"Symptoms in 400 patients referred to palliative care services: Prevalence and patterns","volume":"17","author":"Potter","year":"2003","journal-title":"Palliat Med."},{"key":"ref_4","first-page":"236","article-title":"Constipation: Evaluation and Management","volume":"115","author":"Jani","year":"2018","journal-title":"Mo Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"4723","DOI":"10.1007\/s00520-021-06023-0","article-title":"Severity of constipation related to palonosetron during first-line chemotherapy: A retrospective observational study","volume":"29","author":"Kimura","year":"2021","journal-title":"Support Care Cancer"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"414","DOI":"10.3389\/fphar.2016.00414","article-title":"Chemotherapy-Induced Constipation and Diarrhea: Pathophysiology, Current and Emerging Treatments","volume":"7","author":"McQuade","year":"2016","journal-title":"Front Pharmacol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1097\/j.pain.0000000000000895","article-title":"Prevalence and incidence of chronic pain with or without neuropathic characteristics in patients with cancer","volume":"158","author":"Bouhassira","year":"2017","journal-title":"Pain"},{"key":"ref_8","first-page":"32","article-title":"Observational and cross-sectional study of prevalence and severity of the opioid-induced bowel dysfunction","volume":"46","author":"Provencio","year":"2014","journal-title":"Aten Primaria"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1016\/j.sjpain.2017.01.006","article-title":"Healthcare resource use and costs of opioid-induced constipation among non-cancer and cancer patients on opioid therapy: A nationwide register-based cohort study in Denmark","volume":"15","author":"Christensen","year":"2017","journal-title":"Scand J. 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