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  4. Relationship between neurogenic bowel dysfunction severity and functional status, depression, and quality of life in individuals with spinal cord injury

Relationship between neurogenic bowel dysfunction severity and functional status, depression, and quality of life in individuals with spinal cord injury

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2021.2021043 · Published: May 1, 2023

Spinal Cord InjuryParticipationGastroenterology

Simple Explanation

This study investigated the link between the severity of neurogenic bowel dysfunction (NBD) and various factors like functional status, depression, and quality of life in people with spinal cord injury (SCI). The goal was to identify factors that might lead to moderate to severe NBD. The study found that individuals with moderate to severe NBD experienced greater dependency in daily activities and had lower scores on physical functioning compared to those with very minor NBD. Completeness of the spinal cord injury was identified as a significant factor in the development of moderate to severe NBD. These findings suggest that managing NBD, particularly in individuals with complete SCI, could improve their ability to perform daily tasks, participate in social activities, and reduce feelings of anxiety and depression. Further research is needed to explore how improving functional status can reduce NBD-related issues.

Study Duration
June 2017 and October 2018
Participants
92 individuals with traumatic SCI, at least one year post-injury
Evidence Level
Cross-sectional study

Key Findings

  • 1
    Half of the individuals with SCI in the study had moderate-to-severe NBD.
  • 2
    Individuals with moderate and severe NBD had lower motor FIM and SF-36 physical functioning scale scores than individuals with very minor NBD.
  • 3
    Individuals with complete SCI (AIS A) were more likely to develop moderate-to-severe NBD compared to those with incomplete injuries (AIS C and AIS D).

Research Summary

The study aimed to evaluate the relationship between the severity of neurogenic bowel dysfunction (NBD) and functional status, depression, and quality of life (QoL) in individuals with spinal cord injury (SCI). It also sought to identify factors associated with developing moderate-to-severe NBD. The results indicated that individuals with moderate-to-severe NBD had higher levels of dependency in activities of daily living (ADLs) and lower scores on the SF-36 physical functioning (PF) scale compared to those with very minor NBD. Completeness of injury, as assessed by the American Spinal Injury Association Impairment Scale (AIS), was found to be a significant factor in the development of moderate-to-severe NBD. The authors concluded that clinicians should closely monitor individuals with complete SCI, especially those with increased NBD severity. They suggest that early detection and effective management of NBD in these individuals might reduce their time spent on bowel care, decrease the need for help in ADLs, and improve their participation in social activities, ultimately leading to improved QoL.

Practical Implications

Targeted Monitoring

Clinicians should closely monitor individuals with complete SCI for NBD.

Early Intervention

Early detection and management of NBD can potentially improve functional status and quality of life.

Rehabilitative Efforts

Future research should focus on rehabilitative efforts to enhance functional status and reduce NBD-related complaints.

Study Limitations

  • 1
    Single-center, cross-sectional study
  • 2
    Small sample size with a relatively low proportion of individuals with cervical lesions
  • 3
    Lack of assessment of bowel management methods

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