The Effect of Exercise and Vagus Nerve Stimulation on the Intestines in Irritable Bowel Syndrome
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 90
- 试验地点
- 1
- 主要终点
- Change in IBS Symptom Severity as Measured by IBS-SSS
研究概览
简要总结
The aim of the study was to consider the possible role of exercise and vagus nerve on bowel functionality in chronic IBS and to demonstrate that exercise and transcutaneous auricular stimulation of the vagus nerve can reduce these symptoms in the treatment of these patients.
详细描述
The study will consist of people living in the Manchester region who are diagnosed with chronic IBS and who want to volunteer for the study. Informed consent forms will be signed by all volunteers and these forms will be kept in the file. The number of people who will participate in the study was determined using G Power analysis and the number of samples was calculated as 1st group 30 people, 2nd group 30 people and 3rd group 30 people, totalling 90 people. Individuals with IBS were randomly divided into three groups and diet only [low FODMAP diet (fermentable oligo-di-mono-saccharides and polyols)], diet + aerobic exercise and diet + vagustim will be applied.
- st group: The specified diet will be applied for 4 weeks.
- nd group: Aerobic exercise will be applied 3 days a week (every other day) with the diet programme determined for 4 weeks.
- rd group: Vagustim will be applied 3 days a week (every other day) with the diet programme determined for 4 weeks.
The low FODMAP (fermentable oligo-di-mono-saccharides and polyols) diet to be applied for the nutrition of the participants will be given to each individual as training before the study. In our study, vagus nerve stimulation will be applied through the ear. Aerobic exercises will be demonstrated one-to-one and the application of the patients will be monitored and the vagustim device will be applied to the groups in the clinic. In the intervention group, the vagustim device consisting of earphones placed in the outer ear, which can be selected as S, M, L according to the size of the individual's ear, and a tens device connected to the earphones will be used. The earphones will be placed to hit the tragus and concha and the device will be applied for 30 minutes with a pulse duration of less than 500 microseconds, frequency of 10 Hz and modulated TENS mode, and the current intensity will be adjusted according to the sensory threshold of the individual.
The group given aerobic exercise will be given walking exercise for 4 weeks, 3 days a week, for at least 30 minutes and at a moderate intensity not exceeding 50-70% of the maximal heart rate (if the pulse cannot be counted during sports, the criterion is that the person can talk comfortably). In our study, the decision of aerobic exercise to be given to a group was made by reviewing the literature.
Heart rate variability of the participants before and after the study will be evaluated with Polar H10 HR heart rate sensor. The bowel sounds of the participants before and after the study will be measured using a Littmann 4100 model electronic stethoscope. The first and last measurements will be measured according to the same standards and these standards are as follows: The measurements will be performed 2 hours after the last meal of the person who has not smoked for the last 2 hours before the measurements and has not consumed alcohol (permitted amount) in the last 12 hours. At the same time, 'Sociodemographic Form', 'SF-36', 'International Physical Activity Questionnaire Short Last 7 Days Self-Administered Form', 'Bristol Stool Form Scale (BSFS)' and 'Irritable Bowel Syndrome- Symptom Severity Scale (IBS-SSS)' scales will be applied to the individuals.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
盲法说明
No parties are masked in this clinical trial. All participants, care providers, investigators, and outcomes assessors are aware of the assigned interventions.
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •IBS for more than 1 year
- •Patients with persistent IBS symptoms despite standard conventional treatments
- •To be between the ages of 18-65
- •Being suitable for exercise
- •To be willing and voluntary to participate in the thesis study
排除标准
- •People with inflammatory diseases
- •Uncooperative patients
- •Participants do not want to continue working
- •Failure to sign the informed consent form
- •History of additional chronic diseases that may prevent physical activity
- •Pregnancy
- •Long-term use of analgesics for more than 3 months
- •Acute infection in the auricular region
研究组 & 干预措施
1st Group: Low FODMAP Diet Only
Participants in this group will follow a Low FODMAP diet for a period of 4 weeks. The Low FODMAP diet is designed to reduce the intake of fermentable oligosaccharides, disaccharides, monosaccharides, and polyols-types of carbohydrates that are known to cause digestive issues in individuals with IBS. Prior to the start of the study, each participant will receive training on the diet and will be instructed on which foods to avoid and which to include. The goal is to assess the effect of the diet alone on the participants' IBS symptoms, including their bowel function and overall digestive health.
干预措施: Low FODMAP Diet Intervention (Behavioral)
2nd Group: Low FODMAP Diet + Aerobic Exercise
Participants in this group will follow a Low FODMAP diet combined with an aerobic exercise regimen for a duration of 4 weeks. The Low FODMAP diet aims to reduce the intake of fermentable carbohydrates that may trigger IBS symptoms. Along with the dietary intervention, participants will engage in moderate-intensity aerobic exercise, such as walking, three times per week for at least 30 minutes per session. The intensity will be set to 50-70% of their maximum heart rate, and participants will be encouraged to exercise at a level where they can comfortably talk while moving. The goal is to evaluate the combined effect of dietary modification and regular exercise on IBS symptoms, bowel function, and overall health.
干预措施: Aerobic Exercise Therapy (Behavioral)
2nd Group: Low FODMAP Diet + Aerobic Exercise
Participants in this group will follow a Low FODMAP diet combined with an aerobic exercise regimen for a duration of 4 weeks. The Low FODMAP diet aims to reduce the intake of fermentable carbohydrates that may trigger IBS symptoms. Along with the dietary intervention, participants will engage in moderate-intensity aerobic exercise, such as walking, three times per week for at least 30 minutes per session. The intensity will be set to 50-70% of their maximum heart rate, and participants will be encouraged to exercise at a level where they can comfortably talk while moving. The goal is to evaluate the combined effect of dietary modification and regular exercise on IBS symptoms, bowel function, and overall health.
干预措施: Low FODMAP Diet Intervention (Behavioral)
3rd Group: Low FODMAP Diet + Vagus Nerve Stimulation (Vagustim)
Participants in this group will follow a Low FODMAP diet combined with vagus nerve stimulation (Vagustim) for 4 weeks. The Low FODMAP diet is designed to reduce the intake of fermentable carbohydrates, which are known to trigger IBS symptoms. In addition to the dietary intervention, participants will receive vagus nerve stimulation via an ear-based device (Vagustim), applied three times a week. This device will be used for 30-minute sessions, with settings tailored to each participant's sensory threshold. Vagus nerve stimulation is believed to positively influence the autonomic nervous system and may improve IBS symptoms by reducing inflammation and modulating gut-brain signaling. The combined effect of diet and vagus nerve stimulation will be assessed to evaluate their impact on IBS symptoms, bowel function, and overall wellbeing.
干预措施: Auricular Vagus Nerve Stimulation (aVNS) (Device)
3rd Group: Low FODMAP Diet + Vagus Nerve Stimulation (Vagustim)
Participants in this group will follow a Low FODMAP diet combined with vagus nerve stimulation (Vagustim) for 4 weeks. The Low FODMAP diet is designed to reduce the intake of fermentable carbohydrates, which are known to trigger IBS symptoms. In addition to the dietary intervention, participants will receive vagus nerve stimulation via an ear-based device (Vagustim), applied three times a week. This device will be used for 30-minute sessions, with settings tailored to each participant's sensory threshold. Vagus nerve stimulation is believed to positively influence the autonomic nervous system and may improve IBS symptoms by reducing inflammation and modulating gut-brain signaling. The combined effect of diet and vagus nerve stimulation will be assessed to evaluate their impact on IBS symptoms, bowel function, and overall wellbeing.
干预措施: Low FODMAP Diet Intervention (Behavioral)
结局指标
主要结局
Change in IBS Symptom Severity as Measured by IBS-SSS
时间窗: Pre- and post-intervention (after 4 weeks of Low FODMAP diet only, Low FODMAP diet + aerobic exercise, or Low FODMAP diet + vagus nerve stimulation). IBS-Symptom Severity Scale (IBS-SSS) will be administered at baseline and after 4 weeks.
The primary outcome measure of this study is the change in IBS symptoms, assessed using the IBS-Symptom Severity Scale (IBS-SSS). This scale evaluates the severity of key symptoms of irritable bowel syndrome, including abdominal pain, bloating, and the frequency and severity of bowel movements. Participants will complete the IBS-SSS questionnaire before and after the 4-week intervention period, which includes the low FODMAP diet, aerobic exercise, or vagus nerve stimulation (Vagustim). The change in the IBS-SSS score will be used to assess the impact of the interventions on symptom severity and provide insight into the efficacy of each treatment approach.
次要结局
- Heart Rate Variability (HRV)(Pre- and post-intervention (after 4 weeks).)
- Bowel Sounds(Pre- and post-intervention (after 4 weeks).)
- Quality of Life (SF-36)(Pre- and post-intervention (after 4 weeks).)
- Physical Activity Levels (IPAQ)(Pre- and post-intervention (after 4 weeks).)
研究者
Harun Dere
Specialist physiotherapist
Bahçeşehir University