Effect of Different Forms of Activity-Based Recovery Training on Bladder, Bowel, and Sexual Function After Spinal Cord Injury.
Charles H Hubscher, Jennifer Wyles, Anthony Gallahar and 4 others
PMID 33278365WHAT IT FOUND
Stand training did not improve bladder, bowel, or sexual function after spinal cord injury.
Arm crank exercise lowered bladder pressure and improved bladder compliance, but bowel and sexual function scores did not change.
Key findings
01Stand training, including cases with additional treatments, did not produce significant urologic benefits, and bladder capacity slightly decreased after training.
02Arm crank exercise significantly reduced bladder pressure and increased compliance, with an average group increase of 6.6 ± 2.5 ml/cmH2O, but did not improve capacity or voiding efficiency.
03Bowel dysfunction scores and sexual function scores did not change significantly after stand or arm crank training.
STILL TO COME
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What it does not show
The sample was small, and one participant withdrew before completing arm crank training. Lower urinary tract comparisons analyzed 17 participants using clean intermittent catheterization, not all 22 recruited. Four stand participants used indwelling suprapubic catheters and were excluded from group comparisons; their baseline bladder capacity was significantly lower than that of participants using clean intermittent catheterization. Stand participants received different concurrent treatments, including neuromuscular electrical stimulation and testosterone gel or placebo in one parent study, so the effect of standing cannot be separated from those treatments. Bowel and sexual function questionnaires may not detect physiological changes, and the sexual function questionnaires were not validated as endpoints in spinal cord injury. Some combined bowel and sexual score summaries included data from a previous LT group, not only the current pilot participants.
Declared interests
No conflicts of interest were declared. The publication types list NIH extramural and non-U.S. government research support.
The easy way to misread this
Do not conclude that stand training improves bladder, bowel, or sexual function after spinal cord injury. The stand group had no significant urologic benefit, and bowel and sexual function scores did not change.