Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury

Autor: Susan J. Harkema, Lynnette R. Montgomery, April N. Herrity, Carolyn S. Williams, Charles H. Hubscher, Claudia A. Angeli, Andrea Willhite
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Questionnaires
Male
030506 rehabilitation
Critical Care and Emergency Medicine
Physiology
medicine.medical_treatment
lcsh:Medicine
Social Sciences
Urinary incontinence
Urine
0302 clinical medicine
Surveys and Questionnaires
Medicine and Health Sciences
Psychology
Prospective Studies
Treadmill
lcsh:Science
Prospective cohort study
Spinal Cord Injury
Defecation
Spinal cord injury
Trauma Medicine
Multidisciplinary
Rehabilitation
Body Fluids
Neurology
Research Design
Sensory Perception
Female
medicine.symptom
Anatomy
0305 other medical science
Traumatic Injury
Sexuality
Locomotion
Research Article
Adult
medicine.medical_specialty
Colon
Bladder
Urology
Urinary Bladder
Surgical and Invasive Medical Procedures
Research and Analysis Methods
Catheterization
03 medical and health sciences
Young Adult
medicine
Nocturia
Humans
Spinal Cord Injuries
Survey Research
business.industry
lcsh:R
Biology and Life Sciences
Renal System
Recovery of Function
medicine.disease
Urodynamics
Physical therapy
lcsh:Q
Sexual function
business
Physiological Processes
Neurotrauma
030217 neurology & neurosurgery
Neuroscience
Zdroj: PLoS ONE
PLoS ONE, Vol 13, Iss 1, p e0190998 (2018)
ISSN: 1932-6203
Popis: Objective Locomotor training (LT) as a therapeutic intervention following spinal cord injury (SCI) is an effective rehabilitation strategy for improving motor outcomes, but its impact on non-locomotor functions is unknown. Given recent results of our labs' pre-clinical animal SCI LT studies and existing overlap of lumbosacral spinal circuitries controlling pelvic-visceral and locomotor functions, we addressed whether LT can improve bladder, bowel and sexual function in humans at chronic SCI time-points (> two years post-injury). Study design Prospective cohort study; pilot trial with small sample size. Methods Eight SCI research participants who were undergoing 80 daily one-hour sessions of LT on a treadmill using body-weight support, or one-hour of LT and stand training on alternate days, as part of another research study conducted at the Kentucky Spinal Cord Injury Research Center, University of Louisville, were enrolled in this pilot trial. Urodynamic assessments were performed and International Data Set questionnaire forms completed for bladder, bowel and sexual functions at pre-and post-training time points. Four usual care (non-trained; regular at-home routine) research participants were also enrolled in this study and had the same assessments collected twice, at least 3 months apart. Results Filling cystometry documented significant increases in bladder capacity, voiding efficiency and detrusor contraction time as well as significant decreases in voiding pressure post-training relative to baseline. Questionnaires revealed a decrease in the frequency of nocturia and urinary incontinence for several research participants as well as a significant decrease in time required for defecation and a significant increase in sexual desire post-training. No significant differences were found for usual care research participants. Conclusions These results suggest that an appropriate level of sensory information provided to the spinal cord, generated through task-specific stepping and/or loading, can positively benefit the neural circuitries controlling urogenital and bowel functions. Trial registration ClinicalTrials.gov NCT03036527.
Databáze: OpenAIRE
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