Table 1.

Identified studies

DESIGN Author (year) Research design	METHODS (Objective, Population, Bowel Dysfunction Assessment, QoL Outcome Measures)	QoL RESULTS
Adriaansen et al (2015)55 Cross-sectional multicenter study	Objective: Describe bowel management & its outcomes in individuals living with an SCI for at least 10 yrs. Population: Individuals (N=258; age range, 28–65 yrs) who acquired their SCI between 18 & 35 yrs of age, who were at least 10 yr post-SCI, & who used a wheelchair for their daily mobility. NBD Assessment: International SCI Bowel Function Basic Data Set. QoL Outcome Measures: NBD score, a simple rating scale.	1. Severe NBD was present in 36% of all participants & in 40% of those using a conservative method. However, only 14% were (very) dissatisfied with their current bowel management. 2. Dissatisfaction with bowel management was significantly associated with constipation & severe NBD. 3. With increasing time since injury, there was a nonsignificant trend observed toward a decline in dissatisfaction with bowel management & a significant decline in severe NBD.
Anson et al (1993)44 Cross-sectional & longitudinal survey	Objective: Explore relationships among social support, adjustment, & secondary complications in persons with SCI. Population: 125 persons with SCI, 18 yrs + YPI > 1 yr. NBD Assessment: SCI QLI QoL Outcome Measures: SCI QLI; RSS scale.	4. Social adjustment was associated with the number of diarrhea events. 5. Getting advice was negatively (r = −.029) associated with number of diarrhea events (p < .05). 6. No differences in diarrhea or constipation between high- & low-level support groups.
Branagan et al (2003)43 Cross-sectional survey	Objective: Evaluate the effect of intestinal stoma formation in SCI patients. Population: 32 (27 men) patients with SCI (tetraplegia, paraplegia), mean age at onset 28.9 (range, 6–62 yrs), mean time of injury to stoma formation 17.1 mos (0–36.25). NBD Assessment: Presence of stoma QoL Outcome Measures: Nonstandardized study-specific questionnaire.	1 18 patients reported that a stoma gave them ↑ independence, 12 reported no difference, & 1 felt his independence ↓ despite a significant ↓ time spent in bowel care. 2. QoL after stoma formation was described as much better by 25 patients, as better by 5, & QoL as worse by 1.
Christensen et al (2000)31 Cross-sectional survey	Objective: Evaluate an ECC & MACE in patients with SCI. Population: 21 patients (10 men) with SCI offered ECC, mean age 39.9 (range, 7±72 yrs). 8 patients with SCI (3 men) + MACE, mean age 32.8 (range, 15–66 yrs). NBD Assessment: Single capsule with 24 or 10 radiopaque markers followed by abdominal X-ray; bowel management techniques. QoL Outcome Measures: Nonstandardized study-specific questionnaire.	1. Before treatment with the ECC, 7 out of 11 patients available for follow-up felt that colorectal dysfunction imposed a major restriction on their QoL & social activities. 2. Before treatment with the ECC, 2 patients reported some restrictions, 1 reported a minor restriction, & 1 failed to answer the question. 3. At follow-up, 2 patients reported that colorectal dysfunction caused only some or little restriction & 3 patients reported no restriction. 4. At follow-up, 2 felt some restriction, 6 reported a minor restriction, & 6 reported no restriction. 5. Before MACE, 3 out of 5 patients were available at follow-up.
Christensen et al (2006)29 Prospective, randomized controlled multicenter trial	Objective: Compare outcomes of transanal irrigation vs conservative bowel management in patients with SCI. Population: 87 patients (18 men) with SCI, median age 31.6 ± 13.3 yrs. NBD Assessment: St. Mark's Fecal Incontinence; CCCSS; Modified American Society of Colorectal Surgeon fecal incontinence scores. QoL Outcome Measures: NBD score	1. Compared with conservative bowel management, transanal irrigation improves constipation, fecal incontinence, & symptom-related QoL.
Christensen et al (2008)28 Prospective, randomizedcontrolled multicenter trial	Objective: Compare the symptoms of NBD in patients with SCI at baseline & after 10 weeks of treatment with transanal irrigation & identify possible factors that could predict treatment outcome. Population: 62 patients (45 men) with SCI (supraconal conal/cauda equina, complete, incomplete), mean age 47.5 ±15.5. NBD Assessment: Transanal irrigation, CCCSS; St. Mark's Fecal Incontinence. QoL Outcome Measures: NBD score	1. Scores on the NBD improved from baseline to termination (p < .0001). 2. Regression analyses revealed that there was a reduction in the impact of bowel dysfunction on QoL but depended significantly on complete injury, being male, & ability to walk & varied significantly between study centres.
Coggrave et al (2009)45 Cross-sectional survey	Objective: Describe bowel management in community dwelling persons with SCI & explore associations between age, injury, dependency problems, interventions, & satisfaction. Population: 1,334 persons (73.4% men) with SCI, median age 52 (19–91 yrs), median YPI 18 (1–65 yrs). NBD Assessment: Self-report (survey). QoL Outcome Measures: Nonstandardized study-specific questionnaire.	1. Bowel dysfunction impacted on life activities to varying degrees & impact of bowel dysfunction was rated as significantly ↑ (p .001) than other aspects of SCI. 2. 20% of respondents were dissatisfied or very dissatisfied with bowel management & low satisfaction was associated with more frequent incontinence (p < .001), more problems (p < .001), longer duration of care (p< .001), more management (p = .008), & more interventions used (p < .001).
Coggrave et al (2013)15 Multicentre, retrospective self-report postal survey	Objective: Characterize SCI individuals with a stoma, their stoma management & outcomes, identify sources of information & support for decision making & explore the impact of a stoma on life satisfaction. Population: 92 individuals, mean age 56 yrs, mean duration of injury 26 yrs, 91% with colostomy, 9% ileostomy. NBD Assessment: Self-report (survey). QoL Outcome Measures: Nonstandardized study-specific questionnaire (accompanied by TSCS, SWLS, & HADS) & 3-item nonstandardized questionnaire.	1. Satisfaction with stoma was high; provision of sufficient information preoperatively was important, those with ileostomy were more dependent & less satisfied. 2. Life satisfaction & physical self-concept were both lower in this sample than in previously reported samples of SCI individuals without reported bowel difficulties or stoma.
Craven et al (2012)46 Cross-sectional survey	Objective: Describe the relationships between secondary health conditions & health preference post SCI. Population: 357 persons (218 men) with SCI (AIS A-D), mean age 54.0 (range, 24–89), mean YPI 19.3 (range, 2–65). NBD Assessment: Bowel dysfunction item from the SCS. QoL Outcome Measures: HUI-III.	1. Persons in no/mild bowel dysfunction group had ↑ (p < .0001) HUI-III scores than those in the moderate/severe bowel dysfunction group.
Del Popolo et al (2008)37 Pre-post intervention	Objective: Evaluate the effects of Peristeen Anal Irrigation on NBD & QoL. Population: 36 patients (18 men) with SCI, median age 31.6 ± 13.3 yrs. NBD Assessment: Function, duration of the evacuation disorder, method of defecation, dietary supplements, the need for assistance for evacuation & the predominant intestinal symptom during/after defecation, NBD. QoL Outcome Measures: Nonstandardized study-specific questionnaire.	1. Patient's opinions of their QoL score & degree of satisfaction ↑ from pre- to post-intervention (p = .001). 2. A high percentage of patients reported a change in their level of dependency after the treatment period.
Faaborg et al (2008)56 Longitudinal	Objective: Describe long-term colorectal function in SCI patients. Population: 72 patients (48 men) with SCI, mean age 38.0 ± 11.9 yrs, YPI 37.5 ± 45.2 mos. NBD Assessment: Self-reported constipation, obstructed defecation, & fecal incontinence (survey). QoL Outcome Measures: Non-standardized study specific questionnaire; NBD score.	1. The impact of colorectal dysfunction causing some or major restrictions on QoL or social activities ↑ from 25% to 38% from 1996 to 2006 (p < .005). 2. The impact of constipation influencing QoL ↑ from 15% to 23% from 1996 to 2006 (p < .15).
Glickman & Kamm (1996)4 Cross-sectional survey	Objective: Determine the prevalence, nature, & effects – both physical & psychological – of SCI on bowel function. Population: 115 outpatients (77% men) with SCI, median age 38 (18–75 yrs), median YPI 62 (9–491 mos). NBD Assessment: Self-report (survey). QoL Outcome Measures: HADS; non-standardized questionnaire.	1. Bowel dysfunction was a source of psychological distress in 54% of patients & was associated with time required for bowel management (p = .005) & frequency of incontinence (p = .001). 2. HADS scores correlated significantly with time taken for bowel management. 3. Bowel management problems were rated above urinary problems & not far below loss of mobility, impaired sexual function, & dependence.
Han et al (1998)47 Cross-sectional survey	Objective: Investigate the characteristics of chronic GI problems & bowel dysfunction in patients with SCI. Population: 72 patients (48 men) with SCI, mean age 38.0 ± 11.9 yrs, YPI 37.5 ± 45.2 mos. NBD Assessment: Self-report (survey). QoL Outcome Measures: MBI Score.	1. Bowel dysfunction was unrelated to age, duration, & neurological level of SCI, ASIA score, or level of activity. 2. Post-SCI GI problems were mainly bowel problems such as defecation difficulty (40.3%) & this affected ADL.
Hicken et al (2001)39 Case-control	Objective: Examined the QoL among individuals with SCI requiring assistance for bowel & bladder management compared to those with independent control of their bladders & bowels. Population: 53 matched pairs (49% men): (1) bladder/bowel dependent individuals & (2) bladder/bowel independent individuals, mean age 37.02 yrs, YPI divided into 4 groups (1, 2–5, 6–15, >16 yrs). Groups matched on age, sex, education, race, & lesion level. NBD Assessment: FIM. QoL Outcome Measures: CHART; SWLS; SF-12.	1. The bladder/bowel-dependent individuals reported ↓ life satisfaction & greater overall handicap (p < .001). In particular, persons who were bladder dependent had lower CHART subscale scores than bladder independent group on the following: physical independence (p < .001), mobility (p < .001), & occupational functioning (p < .05). 2. The bladder/bowel independent group initiated more social contact with strangers compared to bladder/bowel-dependent individuals (p = .056). 3. Although there were no group differences concerning social integration, the bladder/bowel-dependent group may have more difficulties initiating new social relationships.
Kachourbos & Creasey (2000)32 Post-intervention cross-sectional survey	Objective: Assess recollections of health & QoL preoperatively in relation to bladder & bowel care & rate changes in QoL post-implant of an implantable stimulator. Population: 16 persons with SCI, 6 mos post surgery. NBD Assessment: Presence of implantable stimulator. QoL Outcome Measures: Non-standardized study specific questionnaire.	1. Bowel program times were reduced from a mean of 5.4 hr per week preoperatively to 2.0 hr per week postoperatively. 2. Respondents reported a greater sense of independence, ↑ socialization, greater control over their lives, improved interpersonal relationships, improved self-image, ↓ feelings of depression, & an overall improvement in QoL.
Kelly et al (1999)30 Retrospective chart review & cross-sectional survey	Objective: Evaluate the long-term outcomes of intestinal stomas post-SCI. Population: 14 patients (16 men) with SCI, mean age 54.8 yrs at time of stoma, mean time from SCI to stoma 15 yrs. NBD Assessment: Presence of stoma. QoL Outcome Measures: Nonstandardized study specific questionnaire. Similar to Dijker's typical QoL measure of ADL.	1. Ten patients reported that colostomy was beneficial to their QoL. One person whose QoL remained unchanged post colostomy reported worse QoL at 10-yr follow-up.
Kim (2012)48 Cross-sectional survey	Objective: Describe defecation stimulation methods & their outcomes & investigate the impact of bowel dysfunction on QoL in SCI. Population: 388 persons with SCI (295 men), mean age 44.5±10.8 yrs, mean YPI 14.2±9.5 yrs. NBD Assessment: Bowel stimulation method, frequency of bowel movements, defecation time, symptoms of AD, frequency of fecal incontinence, & flatus. QoL Outcome Measures: Nonstandardized study-specific questionnaire.	1. Frequency of fecal incontinence had the greatest effects on QoL. 2. When patients had fecal incontinence every day, they had 67.4 times greater chance to obtain severely lowered general QoL. 3. Time taken in defecation >60 min, presence of perianal skin problem, & flatus incontinence also significantly influenced QoL. 4. QoL deterioration differs between each stimulation user. Decline in general QoL was greater in large-volume enemas users than in DRS users. 5. Social QoL deterioration was much more profound in large-volume enemas users than in DRS or finger evacuations users. 6. QoL at home was lower in patients using large-volume enemas than in those using other methods. 7. Mini-enema users had worse QoL at home than digital rectal stim users
Kirk et al (1997)5 Cross-sectional survey	Objective: Describe impact of NBD on life activities. Population: 171 adults (128 men) with SCI, mean age 39.5 ± 14.5 yrs, mean YPI 8.9 ± 8.9. NBD Assessment: Self-report (survey). QoL Outcome Measures: Nonstandardized study-specific questionnaire (Bowel Program Outcome Questionnaire).	1. 61% indicated NBD interfered with their life. 2. 47 of 105 respondents described a loss of freedom to go places, missing work, school or social events, or having to plan their lives around their bowels.
Krogh et al (1997)50 Cross-sectional survey	Objective: Describe the frequency & severity of colorectal problems among patients with spinal cord lesions & determine whether these problems are associated with age, gender, time since lesion, level & severity of lesion. Population: 424 persons with SCI (300 men), mean age 41 (range 8–88 yrs), YPI 41 (range 0–59 yrs). NBD Assessment: Self-report (survey). QoL Outcome Measures: Nonstandardized study-specific questionnaire.	1. 39% reported colorectal dysfunction caused some/major restrictions on social activities or QoL. 2. 29% reported disturbed defecation caused some/major restriction on social activities & 32% reported it caused some/major restriction on QoL. 3. 19% reported fecal incontinence caused some/major restriction on social activities & 20% reported it caused some/major restriction on QoL. 4. 30% reported bowel dysfunction was ↑ than bladder or sexual dysfunction.
Krogh et al (2006)49 Cross-sectional survey	Objective: Develop & validate a symptom-based score for the NBD score. Population: 424 persons (72% men) with SCI, mean age 41 (8–88 yrs), mean YPI 14 (0–88 yrs). NBD Assessment: NBD score. QoL Outcome Measures: NBD score.	1. Several items on the NBD found the impact on QoL ↑ with the severity of symptoms. Frequency of bowel movements was associated with QoL (p < .0001), as was frequency of fecal incontinence. 2. Difference in NBD scores among patients reporting no, little, some, or major impacts on QoL were significant (p < .001). 3. There may be an association between self-reported QoL & restriction of social activities due to bowel dysfunction.
Liu et al (2009)51 Cross-sectional survey	Objective: Assess the relationship between the severity of NBD & HrQoL in persons with various degrees of SCI. Population: 128 (95 men) respondents with SCI, 36 with tetraplegia, 58 with paraplegia, 34 with paresis, mean age 48.3 (range 13–84 yrs), YPI divided into 4 groups (1–2 yrs, 3–5 yrs, 6–10 yrs, & over 10 yrs). NBD Assessment: NBD score. QoL Outcome Measures: SF-36; NBD score.	1. Persons with very minor NBD had the ↑ scores on the SF-36 in contrast to persons with severe NBD, who had the ↓scores. 2. Significant differences were found on the SF-36 physical functioning (p < .001) & the physical component summary (p < .001) subscales. 3. Participants with worse NBD were likely to have ↓physical QoL (p < .001).
Lombardi (2010)33 Retrospective non-blinded design without controls.	Objective: Evaluate the efficacy & safety of sacral neuromodulation in incomplete SCI affected by chronic NBD. Population: 23 patients with SCI (13 men), mean age 36±9 yrs. NBD Assessment: Wexner Score; episodes of fecal incontinence, no. of evacuations/week. QoL Outcome Measures: SF-36.	1. Patients in both groups (constipation & fecal incontienence) had significant ↓ (p < .05) in Wexner scores. 2. QoL in both groups consistently showed statistical improvement (p < .05).
Lombardi et al (2011)34 Retrospective cross-sectional survey	Objective: Assess the concomitant clinical improvement in incomplete SCI with NBD using sacral neuromodulation. Population: 75 patients with incomplete SCI. NBD Assessment: Incontinence & constipation. QoL Outcome Measures: SF-36.	1. Bladder function & incontinence improved. 2. In the general & mental health domains of the SF-36, all patients improved their scores by at least 20% compared with baseline after sacral neuromodulation.
Luther et al (2005)40 Case-control	Objective: Compare QoL for people with NBD & SCI using either a standard care program or colostomy. Population: 74 veterans (73 men) with SCI + colostomy, 296 SCI controls without colostomy, age range < 20–89, YPI within past 20 yr. NBD Assessment: Presence of colostomy. QoL Outcome Measures: IBDQ.	1. No significant differences were detected on IBDQ between persons with SCI + colostomy & those with SCI only.
Lynch et al (2000)10 Controlled, descriptive & comparative questionnaire study	Objective: Describe the bowel function of SCI patients & compare it to a general community control group. Population: 467 SCI patients & 467 control subjects were age & gender matched. Mean age for the SCI patients 43.5 (range, 15–89 yrs), mean YPI 14 (range, 0.7–42.1 yrs). Mean age for the controls 45.3 (range, 17–78 yr). NBD Assessment: General bowel function, incidence of incontinence, & defecation methods. QoL Outcome Measures: Nonstandardized questionnaire.	1. Incontinence affected the QoL for 62% SCI patients compared to 8% of the controls. 2. Incontinence did not affect the majority of the controls (92.3%) in terms of everyday activities compared to 43.9% of SCI patients (p < .0001).
Noonan et al (2008)52 Cross-sectional survey	Objective: Determine the effect of associated SCI conditions on health status & QoL. Population: 70 persons (57 men) with central cord syndrome, mean age at injury 45±18 yrs (range, 13–91), mean age at follow-up 51 ±18 yrs (range, 19–95). NBD Assessment: Self-report (survey). QoL Outcome Measures: SF-36; numeric QoL rating.	1. Bowel, bladder & sexual dysfunction on the physical component score of the SF-36 were significant, but the effect ↓ when controlling for personal & confounding factors. 2. Bowel, bladder & sexual dysfunction were not related to the mental component scores of the SF-36. 3. Problems with bowel, bladder, & sexual dysfunction were significantly (p< .01) associated with QoL when personal & confounding factors were NOT controlled for.
Pardee et al (2012)8 Exploratory, descriptive correlational design	Objective: Investigate the association between characteristics of individuals with SCI & neurogenic bowel & their perceived QoL. Population: 241 surveys; from adults over age 18, diagnosed with SCI & neurogenic bowel more than 2 yrs post injury, AIS of A, B, C, or D & residing in the community. NBD Assessment: Survey of neurogenic bowel characteristics. QoL Outcome Measures: QoL survey.	1. Regardless of the bowel management program 54% (n = 127) were satisfied with current methods. Although time reported to complete bowel programs ranged from 1 to 120 min, there was no difference in rating of satisfaction with time. 2. There was a statistically significant difference between those satisfied & dissatisfied with current bowel management & QoL; those satisfied demonstrated a higher QoL on 3 subscales, work function (p = .021), bowel problems (p < .001), & social function (p < .001). Those dissatisfied with their bowel program perceived a lower QoL & indicated problem of time (p = .001), pain or discomfort (p = .033), & poor results (p < .001).
Randell et al (2001)41 Prospective controlled comparative analysis	Objective: Determine whether a colostomy changes QoL in patients with SCI. Population: 26 (15 men) patients with SCI (tetraplegia, paraplegia) + colostomy, age range 22–87, range of injury to stoma formation 7 mos – 20 yrs. 26 SCI controls (age, gender, injury, & YPI matched) without colostomy. NBD Assessment: Presence of colostomy. QoL Outcome Measures: Burwood QoL Questionnaire.	1. No significant differences were detected on QoL between persons with SCI + colostomy & those with SCI only.
Roach et al (2000)53 Cross-sectional survey	Objective: Examine the relationship between bowel dysfunction, impediment to community integration & QoL in persons with SCI. Population: 103 SCI consumers (76.7% men), mean age 39 yrs, YPI 14 yr. NBD Assessment: Self-report (survey). QoL Outcome Measures: Andrews & Withey (1976) Life Satisfaction Survey; nonstandardized study specific questionnaire on community integration (ICI).	1. Significant negative relationship between subjective severity & 3 ICI measures; the higher the perceived severity of bowel dysfunction, the more it affected (1) personal relationships (p < .01); (2) feelings about themselves (p < .01); (3) their home environment (p < .05). 2. The number of days each month a person stayed at home because of lack of bowel control was associated with all 3 ICI scales (p < .01). The ↑ bowel accidents per month, the ↑ negative a respondent felt about him/herself (p < .05). 3. None of the bowel dysfunction characteristics were significantly related to the satisfaction of life items, but non-parametric analyses revealed that 2 of the ICI items were associated with satisfaction with free time & family life.
Rosito et al (2002)35 Pre-post intervention	Objective: Evaluate the effects of colostomy on the QoL in patients with SCI. Population: 27 patients (26 men) with SCI, mean age of 62.9 (range 44–79 yrs), YPI 25.8 (range 8–48 yrs), mean time since stoma formation 8 (range 1.5–28 yrs), mean time with severe bowel dysfunction 5.5 (range 0.5–18 yr). NBD Assessment: Presence of colostomy. QoL Outcome Measures: Nonstandardized study specific questionnaire. Similar to Dijker's typical QoL measure of ADL.	1. Colostomy improved (p ≤ .0001) total QoL. 2. Significant improvements after colostomy observed in physical health, self-efficacy, psychosocial status, & recreation/leisure but not in body image. 3. 85% of patients reported an ↑ in total QoL after colostomy; 70% of patients were satisfied with their personal lives before colostomy compared to 89% of patients after colostomy. 4. 67% of patients felt more independent after colostomy compared to 30% of patients that felt the same level of independence.
Safadi et al (2003)36 Retrospective chart review & cross-sectional survey	Objective: Evaluate the long-term outcomes of colostomies & ileostomies post SCI. Population: 45 patients (44 men) with SCI, mean age 55.9 yrs, mean time from SCI to stoma 20.3 yrs. NBD Assessment: Presence of stoma. QoL Outcome Measures: Nonstandardized study specific questionnaire.	1. In the right-sided colostomy group (n=20), QoL & health status scores improved (p < .05). 2. In the left-sided colostomy group (n=20), QoL & health status scores improved (p < .05). 3. In the ileostomy group (n=7), QoL & health status scores improved (p < .05).
Teichman et al (2003)79 Retrospective review	Objective: To determine the long-term outcomes from the Malone antegrade continence enema (ACE) procedure in adult neurogenic patients. Population: 6 patients (mean age = 35 yrs), mean follow-up of 4.5 yrs. NBD Assessment: Pre-ACE & post-ACE toileting times, bowel continence status, & complications. QoL Outcome Measures: Nonstandardized questionnaire.	1. Five patients (83%) were satisfied with their outcome & rated their QoL higher after the ACE procedure compared with pre-ACE.
Westgren & Levi (1998)54 Cross-sectional survey	Objective: Determine associations between major outcome variables after SCI & QoL. Population: 320 persons (261 men) with SCI, mean age 42 (17–78 yr), YPI ≤4 yrs & ≥4 yrs. NBD Assessment: Medical records via clinical database. QoL Outcome Measures: SF-36.	1. Bowel dysfunction was associated with ↓ QoL. 2. Bowel dysfunction yielded a medium effect sizes in the general physical functioning (p = .001), bodily pain (p = .003), general health (p = .001), vitality (p = .001), social function (p = .004), & mental health (p = .001) subscales.
Worsøe et al (2008)42 Retrospective chart review & cross-sectional survey	Objective: Evaluate the long-term outcomes of ACE & ACE + colostomy in patients with SCI. Population: 80 patients (12 men) with SCI, mean age 51 yrs at time of stoma, mean follow-up time was 75 mos (range, 3–183). NBD Assessment: Continued ACE or ACE+colostomy at follow-up; Wexner score. QoL Outcome Measures: Nonstandardized study-specific questionnaire.	1. 34 of 43 patients still using ACE were satisfied or very satisfied with the result, 8 patients were neither satisfied nor dissatisfied, & none were dissatisfied or very dissatisfied. One person did not provide a response. 2. On an arbitrary scale (0–100) mean values for bowel function before & after were 12 & 81 respectively (p < .01). For social function, the corresponding values were 30 & 81 (p < .01) & for QoL they were 28 & 81 (p < .01).
Tulsky et al (2015)57 Mixed-methods design	Objective: To describe the development & psychometric properties of the SCI-QoL Bladder Management Difficulties & Bowel Management Difficulties item banks & Bladder Complications scale. Population: 757 adults with traumatic SCI of traumatic etiology, 18 yrs of age & older. NBD Assessment: N/A QoL Outcome Measures: In development.	1. The SCI-QoL Bladder Management Difficulties & Bowel Management Difficulties item banks are psychometrically robust & are available as computer adaptive tests or short forms.

Note: Studies are listed in alphabetical order according to the last name of the first author. ACE = antegrade colonic enema; AD = autonomic dysreflexia; ADL = activities of daily living; AIS = American Spinal Injury Association Impairment Scale; CHART = Criag Handicap and Assessment Reporting Technique; CCCSS = Cleveland Clinic Constipation Scoring System; DRS = digital rectal stimulation; ECC = enema continence catheter; FIM = Functional Independence Measure; GI = gastrointestinal; HADS = Hospital Anxiety & Depression Scale; HrQoL = health-related quality of life; HUI = Health Utilities Index; ICI = impediments to community integration; MBI = Modified Barthel Index; mos = months; NBD = neurogenic bowel dysfunction; N/A = not available; QLI = Quality of Life Index; QoL = quality of life; RSS = Reciprocal Support Scale; SCI = spinal cord injury(ies); SCS = Secondary Condition Scale; SF-12 = Short-Form 12; SF-36 = Short-Form 36; SWLS = Satisfaction with Life Scale; YPI = years post injury; yr(s) = years.