| Autor: |
Gorman PH; Department of Neurology, University of Maryland School of Medicine, Baltimore, MD 21201, USA.; Division of Rehabilitation Medicine, University of Maryland Rehabilitation and Orthopaedic Institute, Baltimore, MD 21207, USA., Forrest GF; Kessler Foundation, West Orange, NJ 07052, USA.; Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School-Rutgers University, Newark, NJ 07103, USA., Asselin PK; Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, NY 10468, USA.; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA., Scott W; VA Maryland Healthcare System, Baltimore, MD 21201, USA., Kornfeld S; Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, NY 10468, USA.; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA., Hong E; Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, NY 10468, USA.; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA., Spungen AM; Spinal Cord Damage Research Center, James J. Peters VA Medical Center, Bronx, NY 10468, USA.; Department of Rehabilitation and Human Performance, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. |
| Abstrakt: |
Bowel function after spinal cord injury (SCI) is compromised because of a lack of voluntary control and reduction in bowel motility, often leading to incontinence and constipation not easily managed. Physical activity and upright posture may play a role in dealing with these issues. We performed a three-center, randomized, controlled, crossover clinical trial of exoskeletal-assisted walking (EAW) compared to usual activity (UA) in people with chronic SCI. As a secondary outcome measure, the effect of this intervention on bowel function was assessed using a 10-question bowel function survey, the Bristol Stool Form Scale (BSS) and the Spinal Cord Injury Quality of Life (SCI-QOL) Bowel Management Difficulties instrument. Fifty participants completed the study, with bowel data available for 49. The amount of time needed for the bowel program on average was reduced in 24% of the participants after EAW. A trend toward normalization of stool form was noted. There were no significant effects on patient-reported outcomes for bowel function for the SCI-QOL components, although the time since injury may have played a role. Subset analysis suggested that EAW produces a greater positive effect in men than women and may be more effective in motor-complete individuals with respect to stool consistency. EAW, along with other physical interventions previously investigated, may be able to play a previously underappreciated role in assisting with SCI-related bowel dysfunction. |
