Effects of Electroacupuncture on the Daily Rhythmicity of Intestinal Movement and Circadian Rhythmicity of Colonic Per2 Expression in Rats with Spinal Cord Injury

Background. Spinal cord injury (SCI) leads to bowel dysfunction. Electroacupuncture (EA) may improve bowel function. Objective. To assess EA on daily rhythmicity of intestinal movement and circadian rhythmicity of colonic Per2 expression in rats with SCI. Methods. Rats were randomized to the sham, SCI, and SCI+EA groups. EA was performed at bilateral Zusanli point (ST36) during daytime (11:00–11:30) for 14 days following SCI. Intestinal transit and daily rhythmicity of intestinal movement were assessed. Circadian rhythmicity of colonic Per2 expression was assessed by real-time RT-PCR. Results. EA shortened the stool efflux time and increased the dry fecal weight within 24 h in SCI rats. Daily rhythmicity of intestinal movements was unaffected by SCI. The expression of colonic Per2 peaked at 20:00 and the nadir was observed at 8:00 in the SCI and sham groups. In the SCI+EA group, colonic Per2 expression peaked at 12:00 and 20:00, and the nadir was observed at 8:00. Conclusion. SCI did not change the circadian rhythmicity of colonic Per2 expression in rats, and daily intestinal movement rhythmicity was retained. EA changed the daily rhythmicity of intestinal movement and the circadian rhythmicity of colonic Per2 expression in rats with SCI, increasing Per2 expression shortly after EA treatment.

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The Effect of Exoskeletal-Assisted Walking on Spinal Cord Injury Bowel Function: Results from a Randomized Trial and Comparison to Other Physical Interventions

Journal of Clinical Medicine ◽

10.3390/jcm10050964 ◽

2021 ◽

Vol 10 (5) ◽

pp. 964

Author(s):

Peter H. Gorman ◽

Gail F. Forrest ◽

Pierre K. Asselin ◽

William Scott ◽

Stephen Kornfeld ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Bowel Function ◽

Bowel Dysfunction ◽

Secondary Outcome ◽

Secondary Outcome Measure ◽

Cord Injury ◽

Patient Reported ◽

Stool Form ◽

Time Since Injury

Bowel function after spinal cord injury (SCI) is compromised because of a lack of voluntary control and reduction in bowel motility, often leading to incontinence and constipation not easily managed. Physical activity and upright posture may play a role in dealing with these issues. We performed a three-center, randomized, controlled, crossover clinical trial of exoskeletal-assisted walking (EAW) compared to usual activity (UA) in people with chronic SCI. As a secondary outcome measure, the effect of this intervention on bowel function was assessed using a 10-question bowel function survey, the Bristol Stool Form Scale (BSS) and the Spinal Cord Injury Quality of Life (SCI-QOL) Bowel Management Difficulties instrument. Fifty participants completed the study, with bowel data available for 49. The amount of time needed for the bowel program on average was reduced in 24% of the participants after EAW. A trend toward normalization of stool form was noted. There were no significant effects on patient-reported outcomes for bowel function for the SCI-QOL components, although the time since injury may have played a role. Subset analysis suggested that EAW produces a greater positive effect in men than women and may be more effective in motor-complete individuals with respect to stool consistency. EAW, along with other physical interventions previously investigated, may be able to play a previously underappreciated role in assisting with SCI-related bowel dysfunction.

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Quantitative assessment-based nursing intervention improves bowel function in patients with neurogenic bowel dysfunction after spinal cord injury

Medicine ◽

10.1097/md.0000000000023354 ◽

2020 ◽

Vol 99 (51) ◽

pp. e23354

Author(s):

Qionghua Yin ◽

Can Wang ◽

Jianhong Yu ◽

Qiufang Zhang

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Quantitative Assessment ◽

Bowel Function ◽

Bowel Dysfunction ◽

Nursing Intervention ◽

Cord Injury ◽

Neurogenic Bowel

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Effect of quantitative assessment-based nursing intervention on the bowel function and life quality of patients with neurogenic bowel dysfunction after spinal cord injury

Journal of Clinical Nursing ◽

10.1111/jocn.14198 ◽

2018 ◽

Vol 27 (5-6) ◽

pp. e1146-e1151 ◽

Cited By ~ 1

Author(s):

Yanyan Zhang ◽

Xiyan Xia ◽

Xuewei Zhuang

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Quantitative Assessment ◽

Life Quality ◽

Bowel Function ◽

Bowel Dysfunction ◽

Nursing Intervention ◽

Cord Injury ◽

Neurogenic Bowel

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Attempted bladder reinnervation and creation of a scratch reflex for bladder emptying through a somatic-to-autonomic intradural anastomosis

Journal of Neurosurgery Pediatrics ◽

10.3171/2013.4.peds12302 ◽

2013 ◽

Vol 12 (1) ◽

pp. 80-86 ◽

Cited By ~ 15

Author(s):

Gerald F. Tuite ◽

Bruce B. Storrs ◽

Yves L. Homsy ◽

Sarah J. Gaskill ◽

Ethan G. Polsky ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Neurogenic Bladder ◽

Bowel Function ◽

Bowel Dysfunction ◽

Bladder Function ◽

Histological Evaluation ◽

Clinical Report ◽

Cord Injury ◽

Patient Reported

An intradural somatic-to-autonomic anastomosis, or Xiao procedure, has been described to create a “skin-CNS-bladder” reflex that improves bladder and bowel function in patients with neurogenic bladder and bowel dysfunction. The authors present their experience with a 10-year-old boy with chronic neurogenic bladder and bowel dysfunction related to spinal cord injury who underwent the Xiao procedure. After undergoing a left L-5 ventral root to left S2–3 intradural anastomosis, the patient reported that his bladder and bowel dysfunction improved between 6 and 12 months. Two years after the procedure, however, he reported that there was no change in his bladder or bowel dysfunction as compared with his condition prior to the procedure. Frequent, systematic multidisciplinary evaluations produced conflicting data. Electrophysiological and histological evaluation of the previously performed anastomosis during surgical reexploration 3 years after the Xiao procedure revealed that the anastomosis was in anatomical continuity but neuroma formation had prevented reinnervation. Nerve action potentials were not demonstrable across the anastomosis, and stimulation of the nerve above and below the anastomosis created no bladder or perineal contractions. This is the first clinical report on the outcome of the Xiao procedure in a child with spinal cord injury outside of China. It is impossible to draw broad conclusions about the efficacy of the procedure based on a single patient with no demonstrable benefit. However, future studies should carefully interpret transient improvements in bladder function, urodynamic findings, and the patient's ability to void in response to scratching after the Xiao procedure. The authors' experience with the featured patient, in whom reinnervation could not be demonstrated, suggests that such changes could be related to factors other than the establishment of a skin-CNS-bladder reflex as a result of a somatic-to-autonomic anastomosis.

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