The effect of exoskeletal-assisted walking on spinal cord injury bowel function: Results from a randomized trial and comparison to other physical interventions

Peter H. Gorman, Gail F. Forrest, Pierre K. Asselin, William Scott, Stephen Kornfeld, Eunkyoung Hong, Ann M. Spungen

Research output: Contribution to journalArticlepeer-review

10 Scopus citations

Abstract

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.

Original languageEnglish
Article number964
Pages (from-to)1-11
Number of pages11
JournalJournal of Clinical Medicine
Volume10
Issue number5
DOIs
StatePublished - 1 Mar 2021

Keywords

  • Bowel function
  • Constipation
  • Exoskeletal walking
  • Spinal cord injury

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