Benefits of activity-based training after spinal cord injury

Benefits of activity-based training after spinal cord injury

Activity-based training has resulted in unexpected benefits for individuals with severe spinal cord injury (SCI). Researchers in the Kentucky Spinal Cord Injury Research Center (KSCIRC) at the University of Louisville have discovered that the training, designed to help individuals with SCI improve motor function, also leads to improved bladder and bowel function and increased sexual desire.

Charles Hubscher, professor and researcher at KSCIRC, has documented those changes in research published in the journal PLOS ONE.

For individuals with severe spinal cord injury, bladder and bowel dysfunction are among the most detrimental factors to their quality of life, even more than the loss of independent mobility.

“Patients with spinal cord injury say they are most concerned by the problems associated with bladder function,” Hubscher said. “These issues contribute heavily to a decline in their quality of life and impacts overall health.”

Bladder dysfunction associated with SCI results in numerous health complications, requiring lifelong management and urological care in the form of catheterisation, drug and surgical interventions, peripheral electrical stimulation and urethral stents. All of these therapies bring with them serious side effects and none substantially improves the basic functions.

To document changes in bladder, bowel and sexual function resulting from activity-based therapy, Hubscher and his colleagues performed urological testing and asked research participants with severe spinal cord injury (SCI) to complete surveys about their bladder and other functions. Eight of the participants received activity-based training, which includes locomotor training, stepping on a treadmill with their body weight supported, and stand training in a specially designed frame. Four participants did not receive training.

The active participants’ functions following training were compared with their own condition prior to training and with individuals not receiving training. Following 80 daily sessions of locomotor training with or without stand training, the active individuals were found to store significantly more urine at safer pressures, reported fewer incidents of night time voiding and reduced general incontinence, as well as improved bowel functioning and increased sexual desire.

Hubscher said: “We hope to further validate those findings by determining if the improvements can lead to elimination of related medications and/or long-term reduction in the number of daily catheters. In addition, we are evaluating the effects of spinal cord epidural stimulation on those circuitries.”

Source: University of Louisville

Reference: Charles H. Hubscher, and others. Improvements in bladder, bowel and sexual outcomes following task-specific locomotor training in human spinal cord injury. PLOS ONE, 2018; 13 (1): e0190998 DOI: 10.1371/journal.pone.0190998

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