{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:25:17Z","timestamp":1787840717671,"version":"build-2784847793"},"reference-count":25,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the therapeutic effect of traditional wooden toothbrush usage on most severe constipation, which usually occurs in spinal cord injury (SCI) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In a quasi-experimental study, 61 SCI patients were selected who had injuries in different spinal levels (cervical, thoracic, and lumbar), and severe constipation from one defection in a few days to 3 weeks. They were recommended to use traditional wooden toothbrush for 5 min twice a day, after breakfast and dinner, over a 6 weeks period. Two proper standard scales, called neurogenic bowel dysfunction (NBD), and \u201cConstipation Assessment Scale (CAS),\u201d were used for evaluating the changes in patients\u2019 gastrointestinal (GI) habits during the period of using the wooden toothbrush. Through these scales (NBD and CAS), the therapeutic effects of traditional wooden toothbrush usage on the severity of constipation before and after intervention were measured.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The mean of NBD and CAS scores were reduced significantly, from 8.95 \u00b1 0.78 and 3.34 \u00b1 0.28; respectively, to 3.03 \u00b1 0.57 and 1.74 \u00b1 0.25, after 6 weeks using traditional wooden toothbrush (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). There was a significant difference in terms of NBD scores in patients with different levels of injury (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.01), particularly in patients with thoracic injury, before (10.52 \u00b1 0.88) and after (3.13 \u00b1 0.78) treatment, respectively (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.0001). Eventually, all symptoms of bowel problems improved significantly after the intervention (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The use of traditional wooden toothbrush lead to the improvement of bowel and defecation problems in SCI patients. Yet more studies, particularly randomized control clinical trials are needed to investigate the effect of using wooden toothbrush on other GI reflexes. In addition, if some clinical trials are devised to study the effects of wooden toothbrush on both conscious and unconscious patients in ICU, best results are expected to be found on keeping their mouth and teeth hygiene, as well as, getting rid of their constipations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijpvm.ijpvm_174_16","type":"journal-article","created":{"date-parts":[[2017,6,23]],"date-time":"2017-06-23T04:59:08Z","timestamp":1498193948000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Novel Effects of Traditional Wooden Toothbrush on Bowel Motility Symptoms in Spinal Cord Injury Patients; Findings from a Pilot Quasi-experimental Study"],"prefix":"10.4103","volume":"8","author":[{"given":"Ebrahim","family":"Esfandiari","sequence":"first","affiliation":[{"name":"Department of Anatomical Sciences and Molecular Biology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Awat","family":"Feizi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Heidari","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed Reza","family":"Tabibian","sequence":"additional","affiliation":[{"name":"Medical Students Research Centre, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooria","family":"Shaabani","sequence":"additional","affiliation":[{"name":"Medical Students Research Centre, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bijan","family":"Iraj","sequence":"additional","affiliation":[{"name":"Isfahan Endocrine and Metabolism Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Payman","family":"Adibi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Integrative Functional Gastroenterology Research Centre, Isfahan University of Medical Sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amrollah Ebrahimi","family":"Varzaneh","sequence":"additional","affiliation":[{"name":"Fellow of Gastroenterology, Department of Internal Medicine, Isfahan University of Medical sciences, Isfahan, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2017,6,23]]},"reference":[{"key":"R1-20250812","first-page":"2277","article-title":"Treatment of constipation in older adults","volume":"72","author":"Hsieh","year":"2005","journal-title":"Am Fam Physician"},{"key":"R2-20250812","doi-asserted-by":"crossref","first-page":"3530","DOI":"10.1111\/j.1572-0241.1999.01642.x","article-title":"Epidemiology of constipation (EPOC) study in the United States: Relation of clinical subtypes to sociodemographic features","volume":"94","author":"Stewart","year":"1999","journal-title":"Am J Gastroenterol"},{"key":"R3-20250812","doi-asserted-by":"crossref","first-page":"750","DOI":"10.1111\/j.1572-0241.2004.04114.x","article-title":"Epidemiology of constipation in North America: A systematic review","volume":"99","author":"Higgins","year":"2004","journal-title":"Am J Gastroenterol"},{"issue":"Suppl 1","key":"R4-20250812","first-page":"S34","article-title":"Constipation in Iran: SEPAHAN systematic review no.5","volume":"3","author":"Iraji","year":"2012","journal-title":"Int J Prev Med"},{"key":"R5-20250812","first-page":"195","article-title":"Management of chronic constipation in the elderly","volume":"43","author":"Kurniawan","year":"2011","journal-title":"Acta Med Indones"},{"key":"R6-20250812","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1007\/BF01536339","article-title":"Physician visits in the United States for constipation: 1958 to 1986","volume":"34","author":"Sonnenberg","year":"1989","journal-title":"Dig Dis Sci"},{"key":"R7-20250812","doi-asserted-by":"crossref","first-page":"461","DOI":"10.2165\/00019053-200523050-00006","article-title":"The health-related quality of life and economic burden of constipation","volume":"23","author":"Dennison","year":"2005","journal-title":"Pharmacoeconomics"},{"key":"R8-20250812","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1046\/j.1365-2036.2001.00982.x","article-title":"Review article: The therapy of constipation","volume":"15","author":"Schiller","year":"2001","journal-title":"Aliment Pharmacol Ther"},{"key":"R9-20250812","first-page":"424","article-title":"The pathophysiology, diagnosis, and treatment of constipation","volume":"106","author":"M\u00fcller-Lissner","year":"2009","journal-title":"Dtsch Arztebl Int"},{"key":"R10-20250812","first-page":"75","article-title":"Gastrointestinal involvement in spinal cord injury: A clinical perspective","volume":"21","author":"Ebert","year":"2012","journal-title":"J Gastrointestin Liver Dis"},{"issue":"Suppl 2","key":"R11-20250812","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/j.1365-2982.2009.01401.x","article-title":"Pathophysiology of colonic causes of chronic constipation","volume":"21","author":"Dinning","year":"2009","journal-title":"Neurogastroenterol Motil"},{"key":"R12-20250812","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1136\/jnnp.74.1.13","article-title":"Constipation in neurological diseases","volume":"74","author":"Winge","year":"2003","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"R13-20250812","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1111\/j.1365-2036.2005.02696.x","article-title":"Review article: The role of serotonergic agents in the treatment of patients with primary chronic constipation","volume":"22","author":"Cash","year":"2005","journal-title":"Aliment Pharmacol Ther"},{"key":"R15-20250812","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1038\/sj.sc.3102121","article-title":"The pattern of colorectal dysfunction changes with time since spinal cord injury","volume":"46","author":"Faaborg","year":"2008","journal-title":"Spinal Cord"},{"key":"R16-20250812","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/j.autneu.2004.02.002","article-title":"The defecation reflex in rats: Fundamental properties and the reflex center","volume":"111","author":"Nagano","year":"2004","journal-title":"Auton Neurosci"},{"key":"R17-20250812","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1007\/s10350-007-9160-9","article-title":"Sacral nerve stimulation in patients with severe constipation","volume":"51","author":"Holzer","year":"2008","journal-title":"Dis Colon Rectum"},{"key":"R18-20250812","doi-asserted-by":"crossref","first-page":"1005","DOI":"10.1007\/s00384-010-0891-z","article-title":"Sacral nerve stimulation for constipation: Do we still miss something? Role of psychological evaluation","volume":"25","author":"Carriero","year":"2010","journal-title":"Int J Colorectal Dis"},{"key":"R19-20250812","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1046\/j.1365-2036.1998.00305.x","article-title":"Review article: Colonic sensorimotor physiology in health, and its alteration in constipation and diarrhoeal disorders","volume":"12","author":"Camilleri","year":"1998","journal-title":"Aliment Pharmacol Ther"},{"key":"R20-20250812","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1007\/s00268-001-0202-5","article-title":"Short-term effects of sacral nerve stimulation for idiopathic slow transit constipation","volume":"26","author":"Malouf","year":"2002","journal-title":"World J Surg"},{"key":"R21-20250812","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1007\/BF02234782","article-title":"Short-term sacral nerve stimulation for functional anorectal and urinary disturbances: Results in 40 patients: Evaluation of a new option for anorectal functional disorders","volume":"44","author":"Ganio","year":"2001","journal-title":"Dis Colon Rectum"},{"key":"R22-20250812","doi-asserted-by":"crossref","first-page":"2003","DOI":"10.1007\/s00464-008-0016-8","article-title":"Functional evaluation after vagus-nerve-sparing laparoscopically assisted distal gastrectomy","volume":"22","author":"Kojima","year":"2008","journal-title":"Surg Endosc"},{"key":"R23-20250812","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1093\/eurheartj\/ehq391","article-title":"Chronic vagus nerve stimulation: A new and promising therapeutic approach for chronic heart failure","volume":"32","author":"De Ferrari","year":"2011","journal-title":"Eur Heart J"},{"key":"R24-20250812","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1113\/jphysiol.1957.sp005703","article-title":"Functional and histological studies of the vagus nerve and its branches to the heart, lungs and abdominal viscera in the cat","volume":"135","author":"Agostoni","year":"1957","journal-title":"J Physiol"},{"key":"R25-20250812","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1111\/j.1526-4610.2010.01825.x","article-title":"Pathological contrast enhancement of the oculomotor and trigeminal nerves caused by intracranial hypotension syndrome","volume":"51","author":"Albayram","year":"2011","journal-title":"Headache"},{"key":"R26-20250812","first-page":"58","article-title":"The morphometrical evaluation of the localizations of oculomotor, trochlear, trigeminal and abducent nerves in the sphenopetroclival region: A microanatomical study","volume":"28","author":"Icke","year":"2011","journal-title":"J Neurol Sci"}],"container-title":["International Journal of Preventive Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/01439446-201708000-00046","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T13:27:39Z","timestamp":1787837259000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/01439446-201708000-00046"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.4103\/ijpvm.ijpvm_174_16","relation":{},"ISSN":["2008-7802","2008-8213"],"issn-type":[{"value":"2008-7802","type":"print"},{"value":"2008-8213","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1]]},"assertion":[{"value":"2016-05-13","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-03-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}