Neurogenic Bowel Dysfunction, Spinal Cord Injury
Conditions
Keywords
Kinesio Taping, Neurogenic Bowel, Constipation, Bowel Management, Spinal Cord Injury Rehabilitation
Brief summary
Neurogenic bowel dysfunction is a common complication of spinal cord injury and may cause constipation, difficulty with defecation, prolonged bowel care, incomplete evacuation, fecal incontinence, and reduced quality of life. This randomized controlled trial aims to evaluate the effectiveness of Kinesio Taping added to a routine bowel management program in adults with spinal cord injury and upper motor neuron-type neurogenic bowel dysfunction. Thirty participants will be randomly assigned to one of two parallel groups. The control group will receive a routine bowel management program, while the intervention group will receive Kinesio Taping in addition to the routine bowel management program. Kinesio Taping will be applied to the lower abdominal and lumbosacral regions three times per week for 4 weeks. The primary outcome will be defecation frequency recorded using a 7-day bowel diary. Secondary outcomes will include stool consistency, defecation duration, perceived constipation severity, neurogenic bowel dysfunction severity, and health-related quality of life. Assessments will be performed before and after the 4-week intervention.
Interventions
OTHERKinesio Taping
Kinesio Taping will be applied to the lower abdominal and lumbosacral regions three times per week for 4 weeks. The tape will remain in place for 2 days and will be removed before the next treatment session. A star-shaped correction technique will be applied to the lumbosacral region with 25%-50% tension. An I-shaped correction technique will be applied to the lower abdominal region between the right and left anterior superior iliac spines. No tension will be applied to the ends of the tape.
BEHAVIORALRoutine Bowel Management Program
Participants will receive an individualized routine bowel management program based on their clinical condition for 4 weeks. The program may include scheduled bowel care, dietary and fluid recommendations, appropriate positioning, physical activity, abdominal massage, rectal evacuation techniques, suppositories, enemas, and oral or rectal laxatives when clinically indicated. Participants will be instructed not to change their usual dietary habits during the study period.
Sponsors
Pamukkale University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessments will be performed by an investigator who is blinded to group allocation. Participants will be instructed not to disclose their treatment allocation to the outcome assessor.
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Adults aged 18 years or older with traumatic or nontraumatic spinal cord injury * Neurological level of injury at T12 or above * Upper motor neuron-type neurogenic bowel dysfunction * Duration of spinal cord injury longer than 6 months * Ability and willingness to provide written informed consent
Exclusion criteria
* Age younger than 18 years * Neurological level of injury below T12 * Gastrointestinal disease diagnosed before the spinal cord injury, including irritable bowel syndrome or inflammatory bowel disease * History of conservative treatment for neurogenic bowel dysfunction within the previous 6 months * Colostomy or history of bowel surgery * Neurological disease other than spinal cord injury that may cause gastrointestinal or anal sphincter dysfunction * Cognitive impairment that may interfere with participation in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Defecation Frequency | Baseline and at the end of the 4-week intervention | Defecation frequency will be recorded using a 7-day bowel diary and expressed as the total number of defecations during a 7-day period. Higher values indicate more frequent bowel movements. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Bristol Stool Form Scale Score | Baseline and at the end of the 4-week intervention | Stool consistency will be assessed using the 7-point Bristol Stool Form Scale. Type 1 indicates separate hard lumps, while Type 7 indicates entirely liquid stool. Types 3 to 5 generally represent softer or more desirable stool consistency. |
| Change in Perceived Constipation Severity | Baseline and at the end of the 4-week intervention | Participants will rate the overall severity of constipation on a 10-cm Visual Analog Scale ranging from 0 to 10. A score of 0 indicates no constipation, while a score of 10 indicates very severe constipation. |
| Change in Neurogenic Bowel Dysfunction Score | Baseline and at the end of the 4-week intervention | Neurogenic bowel dysfunction severity will be assessed using the 10-item Neurogenic Bowel Dysfunction Score. The total score ranges from 0 to 47, with higher scores indicating more severe neurogenic bowel dysfunction. |
| Change in Short Form-36 Health Survey Scores | Baseline and at the end of the 4-week intervention | Health-related quality of life will be assessed using the 36-item Short Form Health Survey. The instrument includes eight subscales, each scored from 0 to 100. Higher scores indicate better perceived health status. |
| Change in Defecation Duration | Baseline and at the end of the 4-week intervention | Defecation duration will be recorded in minutes using a 7-day bowel diary. Participants will record the time required to complete each bowel evacuation. A shorter duration indicates less time spent on bowel care. |
| Change in the Feeling of Complete Evacuation | Baseline and at the end of the 4-week intervention | The feeling of complete bowel evacuation will be recorded in the 7-day bowel diary after each defecation. The outcome will be expressed as the number or proportion of defecations associated with a feeling of complete evacuation during the 7-day assessment period. Higher values indicate more frequent complete evacuation. |
| Change in Straining During Defecation | Baseline and at the end of the 4-week intervention | Straining during defecation will be recorded in the 7-day bowel diary. The outcome will be expressed as the number or proportion of defecations accompanied by straining during the 7-day assessment period. Lower values indicate less frequent straining. |
| Change in Painful Defecation | Baseline and at the end of the 4-week intervention | Painful defecation will be recorded in the 7-day bowel diary. The outcome will be expressed as the number or proportion of defecations associated with pain during the 7-day assessment period. Lower values indicate less frequent painful defecation. |
Countries
Turkey (Türkiye)
Contacts
CONTACTMeltem Gunes Akıncı, MD
Outcome results
None listed