Functional magnetic stimulation of the colon in persons with spinal cord injury

Objective: To evaluate the usefulness of functional magnetic stimulation (FMS) as a noninvasive method to stimulate the colon in individuals with spinal cord injury (SCI). Design: A prospective before-after trial consisting of 2 protocols. Setting: FMS laboratories of 2 SCI centers. Participants: Two able-bodied men and 13 men with SCI levels ranging from C3 to L1. Protocol 1 consisted of 9 subjects, 2 of whom were excluded from the analysis. Protocol 2 consisted of 4 subjects. Intervention: Commercially available magnetic stimulators with round magnetic coils (MCs) were used. Protocol I measured the effects of FMS on rectal pressure by placing the MC on the transabdominal and lumbosacral regions. Protocol 2 consisted of a 5-week stimulation period to investigate the effects of FMS on total and segmental colonic transit times (CTTs). Main Outcome Measure: An increase in rectal pressure and a decrease in CTT by magnetic stimulation. Results: Data were averaged and the standard error of the mean was calculated. Statistically significant changes in rectal pressure and CTT were also measured. Rectal pressures increased from 26.7 +/- 7.44cmH(2)O to 48.0 +/- 9.91cmH(2)O, p = .0037, with lumbosacral stimulation, and from 30.0 +/- 6.35cmH(2)O to 42.7 +/- 7.95cmH(2)O, p = .0015, with transabdominal stimulation. With FMS, the mean CTT decreased from 105.2 to 89.4 hours, p = .02. Conclusion: FMS is able to stimulate the colon and reduce CTT, FMS is a noninvasive, technological advancement for managing neurogenic bowel in patients with SCI.