Tongue-Rotation Exercise Performance Recovers Intestinal Function After Cesarean Delivery: A Prospective Randomized Controlled Trial.

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.