title: Anorectal biofeedback for neurogenic bowel dysfunction in incomplete spinal cord injury.
abstract: METHODS
  A case-control study of prospectively collected data was performed.
  
  
  OBJECTIVE
  To compare anorectal biofeedback (BF) outcomes in patients with incomplete motor spinal cord injury (SCI) and neurogenic bowel dysfunction (NBD) with a group of functional anorectal disorder-matched control patients.
  
  
  METHODS
  Neurogastroenterology Unit affiliated with a Spinal Injury Unit in a tertiary referral centre in Sydney, Australia.
  
  
  METHODS
  All consecutive patients with SCI and NBD referred for anorectal manometry and BF were matched in a 1:2 ratio with age, gender, parity and functional anorectal disorder-matched control patients. Instrumented BF was performed in six nurse-guided weekly visits. Outcomes included changes in anorectal physiology measures, symptom scores and quality-of-life measures.
  
  
  RESULTS
  Twenty-one patients were included. These were matched with 42 patient controls. Following BF, symptom scores improved significantly in both groups, as did effect of bowel disorder on quality of life. Improvement in these measures did not differ between the groups. Patients with SCI and NBD showed improvement in their sensory and motor anorectal function, including lowering of first sensation threshold and more effective balloon expulsion.
  
  
  CONCLUSIONS
  Patients with incomplete motor SCI responded as well to anorectal BF as functional anorectal disorder-matched controls. Spinal cord-injured patients also showed improvement in anorectal sensorimotor dysfunction and balloon expulsion. These novel findings indicate that clinicians should not be dissuaded from considering behaviour-based therapeutic interventions such as anorectal BF in selected spinal cord-injured patients.
authors.affiliation: Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.
authors.forename: Y
authors.initials: Y
authors.lastname: Mazor
authors.affiliation: Psychology Department, Macquarie University, Sydney, NSW, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Jones
authors.affiliation: Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Andrews
authors.affiliation: Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.
authors.forename: J E
authors.initials: JE
authors.lastname: Kellow
authors.affiliation: Neurogastroenterology Unit, Royal North Shore Hospital, University of Sydney, Sydney, NSW, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Malcolm
mesh_terms: D001003:Anal Canal / Q000503:physiopathology; D001676:Biofeedback, Psychology / Q000379:methods*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055496:Neurogenic Bowel / Q000209:etiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D011446:Prospective Studies; D011788:Quality of Life; D012007:Rectum / Q000503:physiopathology; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D016896:Treatment Outcome