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Project

Effects of spinal cord injury and locomotor training on colonic motility.

Funder: Craig H Neilsen Foundation

Funding period
USD 150 K
Funding amount
Abstract
Numerous secondary complications develop after spinal cord injury (SCI), including disruptions of bowel, bladder, and sexual function. Time and again surveys of people with SCI rate these issues as the highest priority, often higher than regaining walking. Dysfunctions in elimination have a substantial impact on the quality of life and engagement in social life for those with SCI. Bowel dysfunctions after SCI include constipation, incredibly long amounts of time (60-180 min) necessary to complete a toileting program, and incontinence. Additionally, bowel distension has been shown to cause autonomic dysreflexia, which is a source of morbidity after SCI. Therefore, bowel care programs become a serious impediment to daily life and a source of dangerous cardiovascular incidents. Despite the importance of these issues, there are few studies specifically focused on understanding bowel dysfunction after SCI. The first specific aim seeks to determine the effect of several variables on bowel function after injury. These are level of injury (T3 vs T8) and severity of injury (sham, mild, moderate, severe). Assessment of bowel function comprises numerous measures: anorectal manometry will be used to assess intra-colonic pressure and contractile changes after SCI; anal sphincter EMG function will be measured so that colonic function and sphincter dynamics after SCI can be compared; twenty-four hour fecal count will be used as a measure of motility; several candidate chemical systems (alpha-2 adrenergic receptor density, substance P content, vasoactive intestinal peptide) will be examined to determine the influence of SCI. These measurements will provide a comprehensive assessment of bowel function and how it varies according to our treatment groups. As a follow-up, specific aim two seeks to determine the effect of activity-based training on bowel function after SCI. Pilot data in humans indicates that step-training reduces the time necessary to complete a bowel program. Therefore, it is likely that locomotor training will improve aspects of bowel function after SCI. This aim will use a high level of injury (T3) and moderate-to-severe contusion injury. Groups will vary according to type of exercise exposure (10 weeks, 5 days per week, 60 minutes per day), quadrupedal stepping (QT), forelimb stepping (FL), or home-cage (HC). We expect the QT group to show the most improvement in bowel function, but there could be an exercise effect as well (FL group). Bowel function will be assessed in the same ways as the first specific aim.The importance of bowel function management cannot be overstated. Evidence-based interventions that improve bowel function will lead to substantial improvement in the quality of life for individuals after SCI. (CHN: SCIRTS chn:wdg)
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System

Categories
  • FOR (ANZSRC)

    1117 Public Health and Health Services

  • RCDC

    Injury (total) Accidents/Adverse Effects

  • RCDC

    Injury - Trauma - (Head and Spine)

  • RCDC

    Digestive Diseases

  • RCDC

    Neurosciences

  • RCDC

    Spinal Cord Injury

  • RCDC

    Clinical Research

  • RCDC

    Neurodegenerative

  • HRCS HC

    Neurological

  • HRCS HC

    Oral and Gastrointestinal

  • Health Research Areas

    Clinical

  • Broad Research Areas

    Clinical Medicine and Science