title: Does regular standing improve bowel function in people with spinal cord injury? A randomised crossover trial.
abstract: METHODS
  A randomised crossover trial.
  
  
  OBJECTIVE
  To determine the effects of a 6-week standing programme on bowel function in people with spinal cord injury.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1] John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, St Leonards, New South Wales, Australia [2] Spinal Injury Unit, Royal Rehab, Ryde, New South Wales, Australia.
authors.forename: S
authors.initials: S
authors.lastname: Kwok
authors.affiliation: 1] John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, St Leonards, New South Wales, Australia [2] Spinal Injury Unit, Royal Rehab, Ryde, New South Wales, Australia.
authors.forename: L
authors.initials: L
authors.lastname: Harvey
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, St Leonards, New South Wales, Australia.
authors.forename: J
authors.initials: J
authors.lastname: Glinsky
authors.affiliation: John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, St Leonards, New South Wales, Australia.
authors.forename: J L
authors.initials: JL
authors.lastname: Bowden
authors.affiliation: 1] The National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire, UK [2] Buckinghamshire New University, Buckinghamshire, UK.
authors.forename: M
authors.initials: M
authors.lastname: Coggrave
authors.affiliation: The National Spinal Injuries Centre, Stoke Mandeville Hospital, Buckinghamshire, UK.
authors.forename: D
authors.initials: D
authors.lastname: Tussler
mesh_terms: D000328:Adult; D001315:Australia; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D011187:Posture / Q000502:physiology*; D012111:Residence Characteristics; D016037:Single-Blind Method; D013119:Spinal Cord Injuries / Q000150:complications*; D013997:Time Factors; D006113:United Kingdom; D001745:Urinary Bladder Diseases / Q000209:etiology* / Q000534:rehabilitation*