Pelvic physiotherapy in the neurogenic bowel of women after spinal cord injury: a retrospective observational study

Authors

DOI:

https://doi.org/10.5433/1679-0367.2025v46n1p43

Keywords:

Spinal cord diseases, Neurogenic bowel, Physical therapy specialty

Abstract

Objective: to report the role of physiotherapy in the treatment of women after spinal cord injury with neurogenic bowel. Methodology: a retrospective observational study was performed in a convenience sample, of women who had sustained a spinal cord injury at an outreach project at a physiotherapy school clinic. The medical records of the sample were analyzed considering the socioclinical questionnaire, the Bristol scale, the Jorge & Wexner Constipation Score and the physiotherapy procedures performed. The analyses were performed using the Statistical Package for the Social Sciences - SPSS® (version 23.0). Results: medical records of 24 women diagnosed with spinal cord injury (levels T6-T11) were analyzed, with a mean age of 56.13 ± 12.22 years and an average time since diagnosis of 29.07 ± 9.71 months. After physiotherapy sessions, the frequency of weekly evacuation increased, fecal consistency improved and the level of anorectal constipation decreased. Final considerations: pelvic physiotherapy improves the evacuation pattern, in women with neurogenic bowel associated with spinal cord injury.

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Author Biographies

Andreina Eloyse Goebel, Universidade Estadual do Centro-Oeste

Physiotherapy undergraduate student at Universidade Estadual do Centro-Oeste (Unicentro), Guarapuava, Paraná, Brazil.

Josiane Lopes, Universidade Estadual do Centro-Oeste

PhD in Health Sciences from the State University of Londrina (UEL), Londrina, Paraná, Brazil. Adjunct Professor in the Physiotherapy Department at Universidade Estadual do Centro-Oeste (Unicentro), Guarapuava, Paraná, Brazil.

References

Abrams P, Andersson KE, Apostolidis A, Birder L, Bliss D, Brubaker L, Cardozo L, Castro-Diaz D, O'Connell PR, Cottenden A, Cotterill N, Ridder D, et al. Incontinence. Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse and Faecal Incontinence. Neurourol Urodyn. 2018;37(7):2271-2. doi: 10.1002/nau.23551.

Albayrak H, Atli E, Aydin S, Ozyemisci-Taskiran O. Successful outcome following a multimodal pelvic rehabilitation program in a woman with neurogenic bladder and bowel dysfunction: a case report. Physiother Theory Pract. 2024;40(5):1083-90. doi: 10.1080/09593985.2022.2144561.

Albuquerque GPM, Faleiros F, França ISX, Carneiro TTA, Lima MAM, Coura AS. Cuidados de enfermagem em programas de reeducação intestinal para pacientes com intestino neurogênico. Cogitare Enferm. 2023;28:e83080. doi: 10.1590/ce.v28i0.91016.

Amaral DC, Silva ABS, Ribeiro RM, Domenico EBL, Moreira RSL, Teacka EC. Intervenções de enfermagem na reabilitação de pessoas com intestino neurogênico: revisão integrativa. Ciênc Cuid Saúde. 2022;21:61197. doi: 10.4025/ciencuidsaude.v21i0.61197.

Anjos MB, Andrade GF, Bortolanza MCZ, Lopes J. Dismenorreia primária e incontinência anal em mulheres jovens nulíparas. REMECS. 2024;9(15):115-25. doi: 10.24281/rremecs2024.9.15.115125.

Azevedo MAR, Lisboa LL, de Medeiros CEB, Almeida VA, Gonçalves RP. Terapia comportamental associada à neuromodulação no tratamento da bexiga e intestino em indivíduos com Parkinson: um estudo piloto. Rev Pesq Fisio. 2021;11(1):50-8. doi: 10.17267/2238-2704rpf.v11i1.3313.

Barbiellini Amidei C, Salmaso L, Bellio S, Saia M. Epidemiology of traumatic spinal cord injury: a large population-based study. Spinal Cord. 2022;60(9):812-9. doi: 10.1038/s41393-022-00795-w.

Bernardi M, Fedullo AL, Bernardi E, Munzi D, Peluso I, Myers J, Lista FR, Sciarra T. Diet in neurogenic bowel management: A viewpoint on spinal cord injury. World J Gastroenterol. 2020;26(20):2479-97. doi: 10.3748/wjg.v26.i20.2479.

Buffon VA, Da Luz WH, Gomes YNC, Sato RMS, Júnior PG, Tabushi FI, Bark SA. Perfil epidemiológico das fraturas traumáticas das colunas torácica e lombar submetidas ao tratamento cirúrgico. Rev Méd. 2021;79(Supl. 1):58-60. doi: 10.55684/79.2.1683.

Burns AS, St-Germain D, Connolly M, Delparte JJ, Guindon A, Hitzig SL, et al. Phenomenological study of neurogenic bowel from the perspective of individuals living with spinal cord injury. Arch Phys Med Rehabil. 2015;96(1):49-55. doi: 10.1016/j.apmr.2014.07.417.

Cotterill N, Madersbacher H, Wyndaele JJ, Apostolidis A, Drake MJ, Gajewski J, Heesakkers J, Panicker J, Radziszewski P, Sakakibara R, Sievert K-D, Hamid R, Kessler TM, Emmanuel A. Neurogenic bowel dysfunction: clinical management recommendations of the Neurologic Incontinence Committee of the Fifth International Consultation on Incontinence 2013. Neurourol Urodyn. 2018;37(1):46-53. doi: 10.1002/nau.23289.

Deng Y, Dong Y, Liu Y, Zhang Q, Guan X, Chen X, Li M, Xu L, Yang C. A systematic review of clinical studies on electrical stimulation therapy for patients with neurogenic bowel dysfunction after spinal cord injury. Medicine (Baltimore). 2018;97(41):e12778. doi: 10.1097/MD.0000000000012778.

Ditunno JF, Cardenas DD, Formal C, Dalal K. Advances in the rehabilitation management of acute spinal cord injury. Handb Clin Neurol, 2012;109:181-95. doi: 10.1016/B978-0-444-52137-8.00011-5.

Emmanuel A. Neurogenic bowel dysfunction. F1000Res. 2019;8:F1000 Faculty Rev-1800. doi: 10.12688/f1000research.20529.1.

Ethier C, Gallego JA, Miller LE. Brain-controlled neuromuscular stimulation to drive neural plasticity and functional recovery. Curr Opin Neurobiol. 2015;33:95-102. doi: 10.1016/j.conb.2015.03.007.

Faleiros-Castro FS, de Paula ED. Constipation in patients with quadriplegic cerebral palsy: intestinal reeducation using massage and a laxative diet]. Rev Esc Enferm USP. 2013;47(4):836-42. Portuguese. doi: 10.1590/S0080-623420130000400010.

Jackson AS, Pollock ML. Generalized equations for predicting body density of men. Br J Nutr. 1978;40(3):497-504. doi: 10.1079/bjn19780152.

Jorge JM, Wexner SD. Etiology and management of fecal incontinence. Dis Colon Rectum. 1993;36(1):77-97. doi: 10.1007/BF02050307.

Kim J, Ayas S, Leblebici B. Effects of abdominal massage on bowel function in patients with spinal cord injury: a randomized controlled trial. Arc Phys Med Rehabil. 2021;102(3):456-62. doi: 10.1097/01.phm.0000247649.00219.c0.

Lu Y, Shang, Z, Zhang W, Pang M, Hu X, Shen R, et al. Incidência global e características da lesão medular desde 2000-2021: uma revisão sistemática e meta-análise. BMC Med. 2024;22. doi: 10.1186/s12916-024-03514-9.

Luo S, Xu H, Zuo Y, Liu X, All AH. A review of functional electrical stimulation treatment in spinal cord injury. Neuromolecular Med. 2020;22:447-63. doi10.1007/s12017-019-08589-9.

Magnuson FS, Christensen P, Krassioukov A, Rodriguez G, Emmanuel A, Kirshblum S, Krogh K. Neurogenic bowel dysfunction in patients with spinal cord injury and multiple sclerosis-an updated and simplified treatment algorithm. J Clin Med. 2023;12(22):6971. doi: 10.3390/jcm12226971.

Mínguez Pérez M, Benages Martínez A. The Bristol scale - a useful system to assess stool form? Rev Esp Enferm Dig. 2009;101(5):305-11. English, Spanish. doi: 1130-0108/2009/101/5/305-311.

Pun MY, Leung PH, Chan TC, Pang C, Chan KH, Kannan P. The effectiveness of physiotherapy interventions on fecal incontinence and quality of life following colorectal surgery: a systematic review and meta-analysis of randomized controlled trials. Support Care Cancer. 2024;32(2):103. doi: 10.1007/s00520-023-08294-1.

Rabeh SAN, Nogueira PC, Caliri MHL Funcionamento intestinal e a relação com a independência funcional de indivíduos com lesão medular. Coluna/Columa. 2013;12(2):153-6. doi: 10.1590/S1808-18512013000200013.

Roberts TT, Leonard GR, Cepela DJ. Classifications in Brief: American Spinal Injury Association (ASIA) Impairment Scale. Clin Orthop Relat Res. 2017;475(5):1499-504. doi: 10.1007/s11999-016-5133-4.

Rodriguez GM, Gater DR. Neurogenic bowel and management after spinal cord injury: a narrative review. J Pers Med. 2022;12(7):1141. doi: 10.3390/jpm12071141.

Santos LTD, Matos GSR, Nogueira PC, Simis M. Effect of transcutaneous abdominal electrical stimulation in people with constipation due to spinal cord injuries: a pilot study. Rev Esc Enferm USP. 2022;56(spe):e20210449. English, Portuguese. doi: 10.1590/1980-220X-REEUSP-2021-0449en.

Singleton C, Bakheit AM, Peace C. The efficacy of functional electrical stimulation of the abdominal muscles in the treatment of chronic constipation in patients with multiplesclerosis: a pilot study. Mult Scler Int. 2016;2016:4860315. doi: 10.1155/2016/4860315.

Sobrinhos LCSL, Lima AAMR, Lacerda WW, Cavalcanti TAS, Silva MHFD, Vieira FC. Trauma raquimedular: panorama atual e perspectivas terapêuticas. Braz J Health Rev. 2024;7(3):01-14. doi: 10.34119/bjhrv7n3-498.

Thomé BI, Borgui IS, Berardi J, Moser AD, Assis GM. Fisioterapia na reeducação do intestino neurogênico como resultado de uma lesão medular [Physiotherapy in the rehabilitation of neurogenic bowel as a result of a spinal cord injury] Manual Therapy, Posturology and Rehabilitation Journal. 2012;10(47):19-27. Portuguese. doi: 10.9736/TERMAN.V10.N47.60.

Published

2025-07-20

How to Cite

1.
Goebel AE, Lopes J. Pelvic physiotherapy in the neurogenic bowel of women after spinal cord injury: a retrospective observational study: . Semin. Cienc. Biol. Saude [Internet]. 2025 Jul. 20 [cited 2025 Dec. 13];46(1):43-52. Available from: https://www.ojs.uel.br/revistas/uel/index.php/seminabio/article/view/52196

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