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Abdominal Electrical Stimulation for Bowel Dysfunction in SCI

Not Applicable
Not yet recruiting
Conditions
Chronic Spinal Cord Injury
Registration Number
NCT06948175
Lead Sponsor
University of Alberta
Brief Summary

Many people with spinal cord injury (SCI) have bowel problems resulting in constipation and need a long time to empty the bowel. Some people spend an hour or more to empty their bowel. The investigators want test if using a small device to deliver electrical pulses to the belly (abdomen), would improve bowel function. The investigators hope that electrical stimulation will shorten the time needed to evacuate the bowel (defecation), improve stool consistency, and speed up food passing through the bowel. A pilot study found that electrical stimulation of the belly can speed up defecation if stimulation is making the abdominal muscles contract and squeeze the belly, which is what the investigators expected. However, some results suggested that people may benefit from low stimulation levels without making the muscles contract.

Therefore, the investigators will do small study at the University of Alberta on 12 people who lived with SCI for more than 1 year, to find out the best way to apply the electrical stimulation, and to better understand how it works. The participants will use an electrical stimulator at home, to stimulate the skin with 4 sticky pads attached over the abdomen, without causing the muscles to contract. During a 2-month period, they will use the stimulator for 30 minutes before every bowel routine. The investigators will compare how long it takes to empty the bowel, stool consistency, and how long it takes for food to pass through the bowel, with and without using the electrical stimulator.

Detailed Description

Not available

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
12
Inclusion Criteria
  1. Traumatic or non-traumatic SCI
  2. >1 year post injury
  3. Injury level C2 - S5 (NLI, neurological level of injury)
  4. AIS A, B, C, D (American Spinal Injury Association Impairment Scale)
  5. Feels defecation takes too long and wants to do something about it
  6. Defecation takes > 30 minutes
Exclusion Criteria
  1. Bladder stimulator
  2. Inflammatory bowel disease
  3. Pregnancy
  4. Unable to give consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Primary Outcome Measures
NameTimeMethod
Mean defecation time at 2 weeks2 weeks after enrollment (after 2 weeks of usual bowel routine)

Mean defecation time for all bowel routines from 0 to 2 weeks (2 weeks of usual bowel routine). Defecation time = time from initiation of bowel movement to the end of stool evacuation.

Mean defecation time at 6 weeks6 weeks after enrollment (after 4 weeks of optimized bowel routine)

Mean defecation time for all bowel routines from 2 to 6 weeks (4 weeks of optimized bowel routine). Defecation time = time from initiation of bowel movement to the end of stool evacuation.

Mean defecation time at 14 weeks14 weeks after enrollment (after 8 weeks of abdominal TES)

Mean defecation time for all bowel routines from 6 to 14 weeks (8 weeks of abdominal TES). Defecation time = time from initiation of bowel movement to the end of stool evacuation.

Mean defecation time at 18 weeks18 weeks after enrollment (after 4 weeks of usual bowel routine)

Mean defecation time for all bowel routines from 14 to 18 weeks (4 weeks of usual bowel routine). Defecation time = time from initiation of bowel movement to the end of stool evacuation.

Secondary Outcome Measures
NameTimeMethod
Bristol Stool FormEvery bowel routine

The Bristol Stool Form Scale will be used to score stool form or consistency. The scale from 1-7 is scored using a 1-page document with a graphic and description of 7 different types of stool

Bowel Transit Time at 2 weeks2 weeks after enrollment (after 2 weeks of usual bowel routine)

Bowel transit time is defined as the time from ingestion of food to time of evacuation, and will be measured using the "corn test". The participants will eat a full can of corn, on its own or with a meal, and write down the date and time of ingestion on a log sheet. They will then inspect stool after every defecation for the presence of corn kernels, and write down the date and time of the first appearance of corn in the stool

Bowel Transit Time at 14 weeks14 weeks after enrollment (after 8 weeks of abdominal TES)

Bowel transit time is defined as the time from ingestion of food to time of evacuation, and will be measured using the "corn test". The participants will eat a full can of corn, on its own or with a meal, and write down the date and time of ingestion on a log sheet. They will then inspect stool after every defecation for the presence of corn kernels, and write down the date and time of the first appearance of corn in the stool

Neurogenic Bowel Dysfunction Score (NBDS) at 6 weeks6 weeks after enrollment (after 4 weeks of optimized bowel routine)

The Neurogenic Bowel Dysfunction Score is a score from 0 to 47 documenting severity of bowel dysfunction, and is based on a 1-page form with 10 questions about frequency and time used for defecation, medication use for constipation and incontinence, use of digital stimulation, fecal incontinence and flatus, peri-anal skin problems

Participant Feedback18 weeks after enrollment (end of study)

At the end of the study, the participants participate in a semi-structured interview (in person or over the phone) to evaluate their level of satisfaction and acceptability of abdominal TES, problems that were encountered, potential benefits they perceived

Bowel Transit Time at 6 weeks6 weeks after enrollment (after 4 weeks of optimized bowel routine)

Bowel transit time is defined as the time from ingestion of food to time of evacuation, and will be measured using the "corn test". The participants will eat a full can of corn, on its own or with a meal, and write down the date and time of ingestion on a log sheet. They will then inspect stool after every defecation for the presence of corn kernels, and write down the date and time of the first appearance of corn in the stool

Bowel Transit Time at 18 weeks18 weeks after enrollment (after 4 weeks of usual bowel routine)

Bowel transit time is defined as the time from ingestion of food to time of evacuation, and will be measured using the "corn test". The participants will eat a full can of corn, on its own or with a meal, and write down the date and time of ingestion on a log sheet. They will then inspect stool after every defecation for the presence of corn kernels, and write down the date and time of the first appearance of corn in the stool

Neurogenic Bowel Dysfunction Score (NBDS) at 18 weeks18 weeks after enrollment (after 4 weeks of usual bowel routine)

The Neurogenic Bowel Dysfunction Score is a score from 0 to 47 documenting severity of bowel dysfunction, and is based on a 1-page form with 10 questions about frequency and time used for defecation, medication use for constipation and incontinence, use of digital stimulation, fecal incontinence and flatus, peri-anal skin problems

Neurogenic Bowel Dysfunction Score (NBDS) at 2 weeks2 weeks after enrollment (after 2 weeks of usual bowel routine)

The Neurogenic Bowel Dysfunction Score is a score from 0 to 47 documenting severity of bowel dysfunction, and is based on a 1-page form with 10 questions about frequency and time used for defecation, medication use for constipation and incontinence, use of digital stimulation, fecal incontinence and flatus, peri-anal skin problems

Neurogenic Bowel Dysfunction Score (NBDS) at 14 weeks14 weeks after enrollment (after 8 weeks of abdominal TES)

The Neurogenic Bowel Dysfunction Score is a score from 0 to 47 documenting severity of bowel dysfunction, and is based on a 1-page form with 10 questions about frequency and time used for defecation, medication use for constipation and incontinence, use of digital stimulation, fecal incontinence and flatus, peri-anal skin problems

Trial Locations

Locations (1)

Glenrose Rehabilitation Hospital

🇨🇦

Edmonton, Alberta, Canada

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