Slater & Gordon : New South Wales clinical trial aims to improve spinal cord injury quality of life through bowel care management

A two-year clinical trial of patients with recent spinal cord injuries will get underway this year, with the aim of improving quality of life through improved bowel care management.

The project is being funded by a $24,953 grant from Slater and Gordon's Health Projects and Research Fund and will be a collaboration between all of the spinal cord injury units in New South Wales and academics from the University of Sydney.

Approximately 130 people in New South Wales and 400 people nationally experience spinal cord injuries every year.

Royal North Shore Hospital Clinical Nurse Consultant Louise Kelly said one of the most debilitating problems people reported was the loss of bowel function.

'When a person suffers a spinal cord injury, the immediate focus is usually on their movement and whether they will be able to walk again,' Ms Kelly said.

'However, research has found that patients consider bowel problems, including constipation and faecal incontinence, as more disabling than the inability to walk.

'Loss of bowel function has a significant impact on physical complications, finances, employment, recreation and social activities, but despite this, the topic receives very little research attention, possibly because it is considered unglamorous or intimately personal.

'We want to tackle this clinical concern head-on in a high-quality trial that answers a very pragmatic question which is imperative to advance nursing knowledge and care.

'The results will translate immediately into clinical practice and will have implications across Australia and internationally where nurses are wrestling with the same dilemma.'

Ms Kelly said the study will compare two different kinds of treatment to determine which offers the best quality of life for patients.

'There are many different elements of bowel care management in patients with spinal cord injuries, but the most important aspect is the administration of enemas,' Ms Kelly said.

'There are two different types of enemas, a high enema and a low enema, which are typically given every morning to stimulate bowel motion.

'There is uncertainty about which type of enema is more appropriate, but we believe a low enema should be used if possible because they are cheaper, less invasive and easier to administer.

'Some believe high enemas give a better bowel result, but this study will determine whether a low enema is as good, if not better, for patients with recent spinal cord injuries.'

Slater and Gordon NSW General Manager Rachael James said this kind of innovative research was exactly the kind of initiative the Health Projects and Research Fund was set up for.

'From motor vehicle crash victims to workplace accidents, we see the life-changing ramifications of spinal cord injuries on a daily basis,' Ms James said.

'Consequently, we also see the amazing work of the New South Wales spinal care units firsthand and we know the huge difference it makes in patients' lives.

'We see the extreme lengths that spinal care nurses, doctors and health workers go to improve the quality of life of their patients and that is why Slater and Gordon is proud to contribute to such important research.'

Study details: Bowel care outcomes in spinal cord injury patients

• Project title: Is the time to complete bowel care as quick, if not quicker using a micro enema compared to high micro enema in people with a recent spinal cord injury?
• Aim: The aim of our project is to investigate the effects of two types of enemas in people with a recent spinal cord injury.
• Participants: 90 people with complete or incomplete spinal cord injuries sustained within the past six months.
• Procedure: Participants will be randomised by concealed allocation to one of two treatment sequences, namely: low enema for 4 weeks followed by high enema for 4 weeks, or high enema for 4 weeks followed by low enema for 4 weeks.
• Collaboration: This project will be a collaborative project between all of the spinal cord injury units in NSW and academics from the University of Sy
• Timeline:
  • 2017: Set up of trial, including preparation of procedures and staff training
  • 2018-2019: Data collection, including recruitment of 90 participants, treatment and assessments.
  • 2020: Compilation of results, including statistical analysis and submission of research for publication in peer reviewed international medical journal