Does regular standing improve bowel function in people with spinal cord injury?

Abstract

Fifteen community-dwelling people with motor complete SCI above T8 participated in a 16-week trial. The trial consisted of a 6-week stand phase and a 6-week no-stand phase separated by a 4-week washout period. Participants were randomised to one of two treatment sequences. Participants allocated to the Treatment First group stood on a tilt table five times per week for 6 weeks and then did not stand for the next 10 weeks. Participants allocated to the Control First group did the opposite: they did not stand for 10 weeks and then stood for 6 weeks. Participants in both groups received routine bowel care throughout the 16-week trial. Assessments occurred at weeks 0, 7, 10 and 17 corresponding with pre and post stand and no-stand phases. The primary outcome was time to first stool. The secondary outcomes were time to complete bowel care and six self-reported outcomes reflecting bowel function and spasticity. Results: The mean (95% CI) between-intervention difference for time to first stool was 4 minutes (-4 to 11) favouring the no-stand phase. Conclusion: A cautious interpretation of the results is that at best, standing may decrease time to first stool by 4 minutes in people with motor complete SCI, but few would consider this sufficient to justify the time and cost associated with regular standing.