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|Does regular standing improve bowel function in people with spinal cord injury? A randomised crossover trial|
|Kwok S, Harvey L, Glinsky J, Bowden JL, Coggrave M, Tussler D|
|Spinal Cord 2015 Jan;53(1):36-41|
|8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: Yes; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*|
STUDY DESIGN: A randomised crossover trial. OBJECTIVES: To determine the effects of a 6-week standing programme on bowel function in people with spinal cord injury. SETTING: Community, Australia and the United Kingdom. METHODS: Twenty community-dwelling people with motor complete spinal cord injury above T8 participated in a 16-week trial. The trial consisted of a 6-week stand phase and a 6-week no-stand phase separated by a 4-week washout period. Participants were randomised to one of two treatment sequences. Participants allocated to the treatment first group stood on a tilt table for 30 min per session, five times per week for 6 weeks and then did not stand for the next 10 weeks. Participants allocated to the control first group did the opposite: they did not stand for 10 weeks and then stood for 6 weeks. Participants in both groups received routine bowel care throughout the 16-week trial. Assessments occurred at weeks 0, 7, 10 and 17 corresponding with pre and post stand and no-stand phases. The primary outcome was time to first stool. There were seven secondary outcomes reflecting other aspects of bowel function and spasticity. RESULTS: There were three dropouts leaving complete data sets on 17 participants. The mean (95% confidence interval) between-intervention difference for time to first stool was 0 min (-7 to 7) indicating no effect of regular standing on time to first stool. CONCLUSION: Regular standing does not reduce time to first stool. Further trials are required to test the veracity of some commonly held assumptions about the benefits of regular standing for bowel function.