Lack of improvement in anorectal manometry parameters after implementation of a pelvic floor/anal sphincter biofeedback in persons with motor-incomplete spinal cord injury.

Autor: Aloysius MM; Department of Medicine, The Wright Center for Graduate Medical Education, Scranton, Pennsylvania, USA.; Department of Medicine, Geisinger Commonwealth School of Medicine, Scranton, Pennsylvania, USA., Korsten MA; National Center for Medical Consequences of Spinal Cord Injury, James J Peters VA Medical Center, Bronx, New York, USA.; Medical Service, James J Peters VA Medical Center, Bronx, New York, USA.; Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA., Radulovic M; National Center for Medical Consequences of Spinal Cord Injury, James J Peters VA Medical Center, Bronx, New York, USA.; Medical Service, James J Peters VA Medical Center, Bronx, New York, USA.; Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA., Singh K; Department of Medicine, College of Medicine, Tucson, Arizona, USA., Lyons BL; National Center for Medical Consequences of Spinal Cord Injury, James J Peters VA Medical Center, Bronx, New York, USA., Cummings T; Bristol Myer's Squibb, Stroudsburg, Pennsylvania, USA., Hobson J; National Center for Medical Consequences of Spinal Cord Injury, James J Peters VA Medical Center, Bronx, New York, USA., Kahal S; Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA., Spungen AM; National Center for Medical Consequences of Spinal Cord Injury, James J Peters VA Medical Center, Bronx, New York, USA.; Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA., Bauman WA; National Center for Medical Consequences of Spinal Cord Injury, James J Peters VA Medical Center, Bronx, New York, USA.; Medical Service, James J Peters VA Medical Center, Bronx, New York, USA.; Department of Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA.; Department of Rehabilitation Medicine, The Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Jazyk: angličtina
Zdroj: Neurogastroenterology and motility [Neurogastroenterol Motil] 2023 Nov; Vol. 35 (11), pp. e14667. Date of Electronic Publication: 2023 Sep 25.
DOI: 10.1111/nmo.14667
Abstrakt: Background: Effect of biofeedback on improving anorectal manometric parameters in incomplete spinal cord injury is unknown. A short-term biofeedback program investigated any effect on anorectal manometric parameters without correlation to bowel symptoms.
Methods: This prospective uncontrolled interventional study comprised three study subject groups, Group 1: sensory/motor-complete American Spinal Injury Association Impairment Scale (AIS) A SCI (n = 13); Group 2 (biofeedback group): sensory incomplete AIS B SCI (n = 17) (n = 3), and motor-incomplete AIS C SCI (n = 8), and AIS D SCI (n = 6); and Group 3: able-bodied (AB) controls (n = 12). High-resolution anorectal manometry (HR-ARM) was applied to establish baseline characteristics in all subjects for anorectal pressure, volume, length of pressure zones, and duration of sphincter squeeze pressure. SCI participants with motor-incomplete SCI were enrolled in pelvic floor/anal sphincter bowel biofeedback training (2 × 6-week training periods comprised of two training sessions per week for 30-45 min per session). HR-ARM was also performed after each of the 6-week periods of biofeedback training.
Results: Compared to motor-complete or motor-incomplete SCI participants, AB subjects had higher mean intra-rectal pressure, maximal sphincteric pressure, residual anal pressure, recto-anal pressure gradient, and duration of squeeze (p < 0.05 for each of the endpoints). No significant difference was evident at baseline between the motor-complete and motor-incomplete SCI groups. In motor-incomplete SCI subjects, the pelvic floor/anal sphincter biofeedback protocol failed to improve HR-ARM parameters.
Conclusion: Biofeedback training program did not improve anal manometric parameters in subjects with motor-incomplete or sensory-incomplete SCI. Biofeedback did not change physiology, and its effects on symptoms are unknown.
Inferences: Utility of biofeedback is limited in patients with incomplete spinal cord injury in terms of improving HR-ARM parameters.
(© 2023 John Wiley & Sons Ltd.)
Databáze: MEDLINE
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