Osteopathic Manipulative Treatments and Neurogenic Bowel Dysfunction in Patients With Spinal Cord Injuries.
Condition: Spinal Cord Injuries
MeSH terms: Intestinal Diseases; Neurogenic Bowel; Spinal Cord Injuries; Wounds and Injuries
Study type: Interventional

Summary: 
      Studies based on the relationship between Osteopathic Manipulative Treatment (OMT) and the
      gastrointestinal system have been conducted in patients with constipation with Irritable
      Bowel Syndrome (IBS), and in children with infantile cerebral palsy. For IBS patients, OMT
      can facilitate visceral vascularization and restore the physiological elasticity and motility
      of the viscera, and of the peritoneal structures around the viscera. The study also focused
      on the effects of OMT on women and constipated children, indicating an improvement in the
      stool consistency, reduction in the symptoms of constipation, the severity of the
      constipation, and in the use of laxative drugs.

      In patients with Spinal Cord Injury (SCI), the secondary health disorders include the
      alteration of gastric acid secretion, abnormal colonic myenteric activity, and neurogenic
      bowel dysfunction (NBD). Patients with NBD present loss or absence of normal bowel function.
      About 80% of SCI is accompanied by NBD resulting in a lower quality of life caused by loss of
      independence, sense of embarrassment, mental disorder, social isolation.

      Conservative treatments for NBD after SCI include oral laxatives, enemas, retroanal
      trans-grade irrigation and digital anorectal stimulation. These treatments are mainly focused
      on promoting intestinal faecal evacuation and on strengthening the anal sphincter to improve
      bowel function. There are no studies that investigate the effects of OMT on patients with
      SCI, however, several studies have already showed the effects of OMT on the nervous system,
      on the hemodynamic system, and on visceral motility. Therefore, the starting hypothesis of
      this study is to use OMT in order to improve the symptoms of NBD in subjects with SCI,
      through a global OMT
    


Intervention name(s): Osteopathic Manipulative treatment (OMT); Manual Placebo (MP)
Intervention type(s): Other; Other
Intervention description(s): OMT techniques were focused on correcting the dysfunctions found before each OMT session and included myofascial techniques, balanced ligamentous tension, visceral manipulations and osteopathy in the cranial field.
OMT group will receive a total of 4 sessions, one time each week for 4 weeks. Each session will last 40 minutes. It will be required by the patients to modify their bowels habits. The subjects will be evaluated right at baseline (T0), after one month (T1) after four sessions (T2) and after 1 month after the treatment (T3).; The MP treatment consists of passive touch without joint mobilization in a protocolled order. The practictioners will be standing next to the bed, they'll touch lumbar and dorsal spine of the subjects in prone position for 10 minutes, and then in supine position, they'll touch for 10 minutes the shoulders, the hips, then the neck, the sternum and the chest for 5 minutes each.
MP group will receive a total of 4 sessions, one time each week for 4 weeks. Each session will last 40 minutes. It will be required by the patients to modify their bowels habits. The subjects will be evaluated right at baseline (T0), after one month (T1) after four sessions (T2) and after 1 month after the treatment (T3).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Primary purpose: Treatment