Relationship between neurogenic bowel dysfunction severity and functional status, depression, and quality of life in individuals with spinal cord injury

Abstract

Objectives/Context: To evaluate the relationship between severity of neurogenic bowel dysfunction (NBD) and functional status, depression, and quality of life in individuals with spinal cord injury (SCI) and to determine the factors associated with developing moderate-to-severe NBD.

Design: Cross-sectional study.

Setting: University hospital rehabilitation outpatient clinic.

Participants: Individuals with traumatic SCI, at least one year post-injury (N = 92).

Interventions: Not applicable.

Main Outcome Measures: Neurogenic Bowel Dysfunction Score, Functional Independence Measure (FIM), Beck Depression Inventory (BDI), and Short Form-36 (SF-36).

Results: In the current sample, we found that half of the individuals with SCI had moderate-to-severe NBD. Individuals with moderate and severe NBD had lower motor FIM (P = 0.008 and P = 0.006, respectively) and SF-36 physical functioning (PF) scale (P = 0.020 and P = 0.031, respectively) scores than individuals with very minor NBD. There was no difference in the BDI scores among individuals with different levels of NBD. Individuals with American Spinal Injury Association Impairment Scale (AIS) A injuries were more likely to develop moderate-to-severe NBD than those with AIS C (odds ratio (OR) = 6.52; 95% confidence interval (CI) 1.13–37.79; P = 0.005) or AIS D (OR = 17.19; 95% CI 3.61–81.82; p < 0.001) injuries.

Conclusion: Individuals with moderate-to-severe NBD had higher levels of dependency in activities of daily living and lower SF-36 PF scale scores than individuals with very minor NBD. Among individuals with SCI, completeness of injury was a significant factor for developing moderate-to-severe NBD.

Keywords:

• Spinal cord injury
• Neurogenic bowel dysfunction
• Functional status
• Quality of life

Data availability statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Disclosure statement

There are no relevant financial or non-financial competing interests to report.

Abbreviations: ADLs: Activities of Daily Living; AIS: American Spinal Injury Association Impairment Scale; BDI: Beck Depression Inventory; BP: Bodily pain; CI: Confidence Interval; FIM: Functional Independence Measure; GH: General Health; MH: Mental Health; NBD: Neurogenic Bowel Dysfunction; NBDS: Neurogenic Bowel Dysfunction Score; OR: Odds Ratio; PF: Physical Functioning; RE: Role Emotional; RP: Role Physical; QoL: Quality of Life; SCI: Spinal Cord Injury; SF: Social Functioning; SF-36: Short Form-36; VT: Vitality

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.