Effects of exoskeleton-assisted walking on bowel function in motor-complete spinal cord injury patients: involvement of the brain–gut axis, a pilot study

Frontiers in Neuroscience, 2024 · DOI: 10.3389/fnins.2024.1395671 · Published: June 17, 2024

Neurology Gastroenterology Rehabilitation

Simple Explanation

This study investigates how using an exoskeleton to help people with complete spinal cord injuries walk affects their bowel function and gut bacteria. The results showed that some participants using the exoskeleton reported improvements in bowel management, like more frequent bowel movements and less need for assistance. The study also found changes in the types of bacteria in the gut of those using the exoskeleton, suggesting a link between walking, gut bacteria, and bowel function in these patients.

Study Duration

8 Weeks

Participants

20 SCI patients (10 EAW group, 10 conventional group), 10 healthy controls

Evidence Level

Clinical Trial

Key Findings

1
EAW training led to a decrease in the amount of glycerol enemas used in the EAW group after 8 weeks of training.
2
The EAW group showed an increasing trend in the neurogenic bowel dysfunction (NBD) score after 8 weeks of training, while the conventional group showed a worsening trend.
3
EAW intervention was associated with changes in gut microbiota composition, including decreased abundance of Bacteroidetes and Verrucomicrobia, and increased Firmicutes, Proteobacteria, and Actinobacteria.

Research Summary

This study evaluated the effects of exoskeleton-assisted walking (EAW) on bowel function and intestinal flora structure in motor-complete paraplegia patients. The results suggest that EAW can improve intestinal function of SCI patients in a limited way and may be associated with changes in the abundance of intestinal flora. The study highlights the need for further research to understand the changes in microbial groups caused by EAW training and their related impact mechanisms, especially intestinal flora metabolites.

Practical Implications

Rehabilitation Strategy

EAW can be considered as a rehabilitation strategy to improve bowel function in SCI patients.

Gut Microbiota Target

Gut microbiota could be a potential therapeutic target for constipation after SCI.

Personalized Treatment

Further research is needed to understand the changes in microbial groups caused by EAW training, and all their associated effects, especially gut microbiota metabolites, in order to develop personalized treatment strategies.

Study Limitations

1
Small sample size limits the statistical power of the study.
2
The study only included male participants, so the results may not be generalizable to female SCI patients.
3
The link between changes in gut microbiota composition and exercise regulation of intestinal function has not been fully demonstrated.

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