Does regular standing improve bowel function in people with spinal cord injury? A randomised crossover trial

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Gastroenterology

Background:

• Spinal cord injury (SCI) frequently leads to significant bowel dysfunction.
• Standing interventions are anecdotally reported to improve bowel function in SCI populations.
• Evidence supporting the efficacy of standing for bowel management in SCI is limited.

Purpose of the Study:

• To investigate the impact of a 6-week standing program on bowel function in individuals with motor-complete SCI.
• To assess the primary outcome of Time to First Stool following a structured standing intervention.
• To explore secondary outcomes related to bowel function and spasticity.

Main Methods:

• A randomized crossover trial involving 20 community-dwelling individuals with SCI (T8 or above).
• Participants underwent alternating 6-week phases of daily standing (30 min, 5x/week) and a no-stand period, separated by a 4-week washout.
• Assessments included Time to First Stool and other bowel function metrics at multiple time points.

Main Results:

• Data from 17 participants were analyzed after three dropouts.
• The mean difference in Time to First Stool between the standing and no-stand phases was 0 minutes (95% CI: -7 to 7), indicating no significant effect.
• No statistically significant improvements were observed in the primary outcome measure.

Conclusions:

• A 6-week regular standing program does not significantly alter the Time to First Stool in individuals with spinal cord injury.
• The findings challenge commonly held beliefs regarding the benefits of standing for bowel function in this population.
• Further rigorous trials are necessary to validate or refute the purported advantages of standing interventions for SCI-related bowel issues.