Changes in Bowel Function Following Exoskeletal-Assisted Walking in Persons with Spinal Cord Injury: An Observational Pilot Study

Spinal Cord, 2020 · DOI: 10.1038/s41393-019-0392-z · Published: April 1, 2020

Spinal Cord Injury Gastroenterology Rehabilitation

Simple Explanation

This study explores how using a robotic exoskeleton to help people with spinal cord injuries (SCI) walk can affect their bowel function. The study found that many participants reported improvements in bowel function, such as more frequent bowel movements, less time spent on bowel management, and fewer accidents. These findings suggest that exoskeletal-assisted walking (EAW) might help improve bowel function in people with SCI, but more research is needed.

Study Duration

12 to 14 weeks

Participants

10 individuals with motor-complete paraplegia

Evidence Level

Not specified

Key Findings

1
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.
2
8/10 reported improved stool consistency and 7/10 reported improved bowel function related QOL.
3
One participant reported worsening of bowel function post-EAW.

Research Summary

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. These preliminary findings suggest that EAW in persons with SCI, by serving as an upright over ground exercise modality analogous to normal walking, may have the potential to improve bowel function, bowel management and related QOL measures and is worthy of further study.

Practical Implications

Improved Bowel Management

Exoskeletal-assisted walking may offer a non-pharmacological approach to improving bowel regularity and reducing the need for medication in SCI patients.

Enhanced Quality of Life

By mitigating bowel dysfunction, EAW can potentially enhance the overall quality of life for individuals with SCI.

Rehabilitation Strategy

EAW may be incorporated into rehabilitation programs as a means of addressing bowel-related issues in SCI patients.

Study Limitations

1
Small sample size (N=10)
2
Improvements observed in this small cohort were not uniform.
3
Findings cannot be generalized because our study was in the end not a randomized clinical trial.

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