1000 Section - Exoskeleton-assisted Walking Combined with Physical Therapy Enhanced Bladder and Bowel Function than Physical Therapy for Individuals with Spinal Cord Injury: A Pilot Study

To determine whether Exoskeleton-assisted Walking (EAW) plus physical therapy improves neurogenic bladder and bowel function more effectively than physical therapy alone in individuals with spinal cord injury.

 

Design:

We conducted a prospective, single-center, assessor-blinded, randomized controlled pilot study. 20 participants with SCI were randomly assigned to an EAW group (n = 10) or a physical therapy group (n = 10) and completed ten 30-minute sessions over two consecutive weeks (5 days/week, 2 weeks). Bladder function was assessed before and after training using the Neurogenic Bladder Symptom Score (NBSS), urodynamic studies and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICI-Q-SF). And bowel function was evaluated with the Neurogenic Bowel Dysfunction Score (NBDS) and the Bristol Stool Form Scale (BSS).


Results:

After 2 weeks training, the values of NBSS total (p = 0.002), NBDS (p = 0.002), ICI-Q-Short From (p = 0.04) and BSS (p = 0.036) reduced significantly in EAW group (NBSS total: 12.7 ± 2.06; NBDS: 8.09 ± 2.51; ICI-Q-Short From: 0 (0); BSS: 4 (3.5,4)) compared with physical therapy group (NBSS total: 25.3 ± 8.74; NBDS: 14.3 ± 2.98; ICI-Q-Short From: 2.5 (0, 6.5); BSS:3 (2,3)). While there was no difference in urodynamics and no adverse event.

 

Conclusion:

Current findings indicated that EAW combined with physical therapy might offer additional benefits for bladder and bowel function in individuals with neurogenic bladder and bowel of SCI, comparing with physical therapy alone. However, urodynamic assessments did not reveal significant changes within the short-term study period.