The research team shows that physical intervention plans that involve walking, rather than just standing, can improve multiple measurements of bowel function
East Hanover, NJ. May 28, 2021. A team of researchers showed that physical intervention plans that included exoskeleton-assisted walking helped people with spinal cord injuries evacuate more efficiently and improve the consistency of their stool. This finding was in. reported Journal of Clinical Medicine on March 2, 2021, in the article “The Effect of Exoskeletal-Assisted Walking on Spinal Cord Injury Bowel Function: Results from a Randomized Trial and Comparison to Other Physical Interventions” (doi: 10.3390 / jcm10050964).
The authors are Peter H. Gorman, MD, of the University of Maryland School of Medicine, Gail F. Forrest, PhD, of the Tim and Caroline Reynolds Center for Spinal Stimulation at the Kessler Foundation, Dr. William Scott of the VA Maryland Healthcare System, Pierre K. Asselin, MS, Stephen Kornfeld, MD, Eunkyoung Hong, PhD, and Ann M. Spungen, EdD, of the James J. Peters VA Medical Center.
Bowel dysfunction, a common experience after a spinal cord injury, can lead to chronic constipation and incontinence, leading to discomfort and frustration. In a survey, more than a third of men with spinal cord injuries said that bowel and bladder dysfunction had the greatest impact on their lives after the injury. Unfortunately, these problems are not easy to deal with.
Rehabilitation professionals have traditionally treated bowel dysfunction with approaches that target the gastrointestinal system or require manual intervention, but some recent research suggests that physical activity and an upright posture can improve bowel motility. However, few studies have explored the possibility that exoskeleton-assisted walking – in which a person with a spinal cord injury wears a robotic suit that allows them to stand and walk – can be an effective addition to existing intervention plans.
In this study, the research team investigated whether exoskeleton-assisted walking improved bowel function in people with chronic spinal cord injury. They conducted a randomized, controlled, crossover clinical study at three centers in which 50 participants completed 36 sessions of exoskeleton-assisted walking. The researchers rated bowel function as a secondary endpoint in 49 participants. Bowel function was measured using a 10-question bowel function survey, the Bristol Stool Form Scale, and the Spinal Cord Injury Quality of Life Bowel Management Difficulties instrument.
The results showed that the exoskeleton-assisted walking program resulted in some improvement in bowel function compared to a control group. “We saw a remarkable reduction in bowel evacuation time, with 24 percent of participants reporting an improved experience,” said Dr. Forrest, co-author and assistant director of the Center for Mobility and Rehabilitation Engineering Research at the Kessler Foundation. “We also found that participants’ bowel movements tended to be more consistent, which supports our hypothesis that this intervention can improve multiple measurements of bowel function.”
“Our results support the idea that walking, not just standing, can have a positive impact on bowel function,” said Dr. Gorman, co-author and director of rehabilitation medicine at the University of Maryland Rehabilitation and Orthopedic Institute. “Our goal is to improve the quality of life for people with chronic spinal cord injuries, and these encouraging results will help inform future studies about the emerging field of mobility intervention.”
Funding: Department of Defense / CDMRP SC130234, Award W81XWH-14-2-0170 and National Center for the Medical Consequences of SCI (B9212-C, B2020-C) at the James J. Peters Veterans Affairs Medical Center. Additional local support was provided by the James Lawrence Kernan Endowment Fund, Baltimore, Maryland; a philanthropic gift from Dr. Bert Glaser at the Baltimore site; and the Bronx Veterans Medical Research Foundation at the Bronx location.
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The Kessler Foundation, a major nonprofit in the disability field, is a world leader in rehabilitation research that improves cognition, mobility, and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries to the brain and spinal cord caused . The Kessler Foundation is a nationwide leader in funding innovative programs that expand employment opportunities for people with disabilities. Find out more at http: // www.
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Contact: Carolann Murphy, PA, Assistant Editor; [email protected]