Abstract
Study design
Prospective, observational study.
Objective
To explore the effects of exoskeletal-assisted walking (EAW) on bowel function in persons with spinal cord injury (SCI).
Setting
Ambulatory research facility located in a tertiary care hospital.
Methods
Individuals 18–65 years of age, with thoracic vertebrae one (T1) to T11 motor-complete paraplegia of at least 12 months duration were enrolled. Pre- and post-EAW training, participants were asked to report on various aspects of their bowel function as well as on their overall quality of life (QOL) as related to their bowel function.
Results
Ten participants completed 25–63 sessions of EAW over a period of 12–14 weeks, one participant was lost to follow up due to early withdrawal after ten sessions. Due to the small sample size, each participant’s results were presented descriptively in a case series format. At least 5/10 participants reported improvements with frequency of bowel evacuations, less time spent on bowel management per bowel day, fewer bowel accidents per month, reduced laxative and/or stool softener use, and improved overall satisfaction with their bowel program post-EAW training. Furthermore, 8/10 reported improved stool consistency and 7/10 reported improved bowel function related QOL. One participant reported worsening of bowel function post-EAW.
Conclusion
Between 50 and 80% of the participants studied reported improvements in bowel function and/or management post-EAW training. EAW training appeared to mitigate SCI-related bowel dysfunction and the potential benefits of EAW on bowel function after SCI is worthy or further study.
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Funding
This study was funded by the Department of Veterans Affairs, Office of Rehabilitation Research and Development Service, National Center for the Medical Consequences of Spinal Cord Injury (VA RR&D #B9212-C) and supported by the James J. Peters VA Medical Center (Bronx, NY).
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AC: Data analysis. Interpretation of the data. Drafting of the manuscript. PKA: Planning and conducting the study. Collecting data. SKn: Planning and conducting the study. Collecting data. SKo: Planning and conducting the study. Collecting data. WAB: Planning and conducting the study. Drafting of the manuscript. MAK: Planning and conducting the study. Drafting of the manuscript. NYH: Conducting study. Drafting of the manuscript. VH: Drafting of the manuscript. AMS: Planning and conducting the study. Data analysis. Interpretation of data. Drafting of the manuscript.
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Chun, A., Asselin, P.K., Knezevic, S. et al. Changes in bowel function following exoskeletal-assisted walking in persons with spinal cord injury: an observational pilot study. Spinal Cord 58, 459–466 (2020). https://doi.org/10.1038/s41393-019-0392-z
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DOI: https://doi.org/10.1038/s41393-019-0392-z
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