Effectiveness of Abdominal Functional Electrical Stimulation for Improving Bowel Function in People With a Spinal Cord Injury: A Study Protocol for a Double-Blinded Randomized Placebo-Controlled Clinical Trial

Top Spinal Cord Inj Rehabil. 2022 Fall;28(4):22-31. doi: 10.46292/sci22-00008. Epub 2022 Nov 15.

Abstract

Background: People with a spinal cord injury (SCI) have a high rate of bowel-related morbidity, even compared with people with other neurological disorders. These complications lower quality of life and place a financial burden on the health system. A noninvasive intervention that improves the bowel function of people with an SCI should reduce morbidity, improve quality of life, and lead to cost savings for health care providers.

Objectives: To investigate the effectiveness of noninvasive abdominal functional electrical stimulation (FES) for improving bowel function in people with a chronic SCI.

Methods: A prospective, double-blinded, 1:1 randomized, placebo-controlled intervention trial will be conducted with 80 adults with chronic SCI (>12 months since injury) above T8 single neurological level. The intervention will be a 45-minute abdominal FES (or placebo) session, 3 days per week, for 6 weeks.

Main study parameters/endpoints: Primary endpoint is whole gut transit time before and after 6 weeks of abdominal FES. Secondary endpoints measured before and after 6 weeks of abdominal FES are (1) colonic transit time; (2) quality of life (EQ-5D-5L); (3) participant-reported bowel function (International SCI Bowel Function Basic Data Set Questionnaire and visual analogue scale); (4) respiratory function (forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure); (5) bladder symptoms (Neurogenic Bladder Symptom Score); (6) daily bowel management diary; and (7) unplanned hospital visits.

Conclusion: Safety data will be collected, and a cost utility analysis using quality of life scores will be performed.

Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621000386831.

Keywords: abdominal functional electrical stimulation; bowel function; respiratory function; spinal cord injury; whole gut transit time.

Publication types

  • Clinical Trial Protocol

MeSH terms

  • Adult
  • Australia
  • Electric Stimulation
  • Humans
  • Prospective Studies
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Spinal Cord Injuries*

Grants and funding

Financial Support This study is supported by New South Wales Health and through three National Health and Research Council of Australia fellowships (J.B., S.G., E.M.).