5. Abdominal Functional Electrical Stimulation (ABFES) for Bowel Management: BOWMAN
Research Team. PI: Dr Tamsyn Street, Dr Rupert Earl*, Dr Chalil Vinod, Ms Mel Williams, Dr Sean Doherty*
Dr Paul Strike, Dr Samir Vyas. (* SCI Patient Perspective Advisors)
Locations: Salisbury NHS Foundation Trust
Duration/Dates/Cost: 36 months/ May 2021-2024 Total project costs: £163,806
A well-managed bowel program is an essential part of daily life for many people with a SCI. Nevertheless, constipation is frequently reported (42-95%). Constipation embraces a spectrum of harms including both physical & psychological distress. Initial exploratory studies suggest abdominal FES may be useful for decreasing overall bowel management time, decreasing colonic transit time and reducing discomfort. Improvements in sexual functioning have also been reported. Abdominal FES may complement or provide an alternative to those with a well-managed bowel program and improve symptoms of constipation. Although previous studies have been encouraging, proof of principle for the use of abdominal FES has not yet been established due to inadequate sample size, brief duration of study and participant inclusion criteria. The current study will address these areas and attempt to reproduce previous findings, using overall bowel management time as a benchmark for establishing proof of principle, consistent with MRC/EME guidelines.
There are a number of potential benefits of ABFES including a reduction in the time required for bowel emptying which is strongly associated with impact on quality of life. Reducing discomfort associated with other interventions, providing greater independence and control over bowel movements, reducing the amount of medication used, enabling a more complete bowel movement and a potential long-term therapeutic benefit. There is also a potential benefit towards decreasing bowel incontinence associated with incomplete bowel emptying. ABFES is also known to help increase abdominal muscle strength which may contribute to an improvement in posture through increased strength to the core muscles. This may contribute to walking for those that are able and transfers to non-walkers. An improved aesthetic appearance of the abdominal muscles has also previously been reported and there have been some reports of improved sexual functioning for males.