Charles H Hubscher1, Jennifer Wyles2, Anthony Gallahar2, Kristen Johnson2, Andrea Willhite2, Susan J Harkema2, April N Herrity2. 1. Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, KY; Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY. Electronic address: chhubs01@louisville.edu. 2. Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY; Department of Neurological Surgery, University of Louisville, Louisville, KY.
Abstract
OBJECTIVES: To investigate whether the urogenital and bowel functional gains previously demonstrated post-locomotor step training after chronic spinal cord injury could have been derived due to weight-bearing alone or from exercise in general. DESIGN: Prospective cohort study; pilot trial with small sample size. SETTING: Urogenital and bowel scientific core facility at a rehabilitation institute and spinal cord injury research center in the United States. PARTICIPANTS: Men and women (N=22) with spinal cord injury (American Spinal Injury Association Impairment Scale grades of A-D) participated in this study. INTERVENTIONS: Approximately 80 daily 1-hour sessions of either stand training or nonweight-bearing arm crank ergometry. Comparisons were made with previously published locomotor training data (step; N=7). MAIN OUTCOME MEASURES: Assessments at both pre- and post-training timepoints included cystometry for bladder function and International Data Set Questionnaires for bowel and sexual functions. RESULTS: Cystometry measurements revealed a significant decrease in bladder pressure and limited improvement in compliance with nonweight-bearing exercise but not with standing. Although International Data Set questionnaires revealed profound bowel dysfunction and marked deficits in sexual function pretraining, no differences were identified poststand or after nonweight-bearing exercise. CONCLUSIONS: These pilot trial results suggest that, although stand and weight-bearing alone do not benefit pelvic organ functions after spinal cord injury, exercise in general may contribute at least partially to the lowering of bladder pressure and the increase in compliance that was seen previously with locomotor training, potentially through metabolic, humoral, and/or cardiovascular mechanisms. Thus, to maximize activity-based recovery training benefits for functions related to storage and emptying, an appropriate level of sensory input to the spinal cord neural circuitries controlling bladder and bowel requires task-specific stepping.
OBJECTIVES: To investigate whether the urogenital and bowel functional gains previously demonstrated post-locomotor step training after chronic spinal cord injury could have been derived due to weight-bearing alone or from exercise in general. DESIGN: Prospective cohort study; pilot trial with small sample size. SETTING: Urogenital and bowel scientific core facility at a rehabilitation institute and spinal cord injury research center in the United States. PARTICIPANTS: Men and women (N=22) with spinal cord injury (American Spinal Injury Association Impairment Scale grades of A-D) participated in this study. INTERVENTIONS: Approximately 80 daily 1-hour sessions of either stand training or nonweight-bearing arm crank ergometry. Comparisons were made with previously published locomotor training data (step; N=7). MAIN OUTCOME MEASURES: Assessments at both pre- and post-training timepoints included cystometry for bladder function and International Data Set Questionnaires for bowel and sexual functions. RESULTS: Cystometry measurements revealed a significant decrease in bladder pressure and limited improvement in compliance with nonweight-bearing exercise but not with standing. Although International Data Set questionnaires revealed profound bowel dysfunction and marked deficits in sexual function pretraining, no differences were identified poststand or after nonweight-bearing exercise. CONCLUSIONS: These pilot trial results suggest that, although stand and weight-bearing alone do not benefit pelvic organ functions after spinal cord injury, exercise in general may contribute at least partially to the lowering of bladder pressure and the increase in compliance that was seen previously with locomotor training, potentially through metabolic, humoral, and/or cardiovascular mechanisms. Thus, to maximize activity-based recovery training benefits for functions related to storage and emptying, an appropriate level of sensory input to the spinal cord neural circuitries controlling bladder and bowel requires task-specific stepping.
Authors: Werner Schäfer; Paul Abrams; Limin Liao; Anders Mattiasson; Francesco Pesce; Anders Spangberg; Arthur M Sterling; Norman R Zinner; Philip van Kerrebroeck Journal: Neurourol Urodyn Date: 2002 Impact factor: 2.696
Authors: Denise G Tate; Tracey Wheeler; Giulia I Lane; Martin Forchheimer; Kim D Anderson; Fin Biering-Sorensen; Anne P Cameron; Bruno Gallo Santacruz; Lyn B Jakeman; Michael J Kennelly; Steve Kirshblum; Andrei Krassioukov; Klaus Krogh; M J Mulcahey; Vanessa K Noonan; Gianna M Rodriguez; Ann M Spungen; David Tulsky; Marcel W Post Journal: J Spinal Cord Med Date: 2020-03 Impact factor: 1.985
Authors: April N Herrity; Sevda C Aslan; Samineh Mesbah; Ricardo Siu; Karthik Kalvakuri; Beatrice Ugiliweneza; Ahmad Mohamed; Charles H Hubscher; Susan J Harkema Journal: Sci Rep Date: 2022-07-01 Impact factor: 4.996