An effective oral vitamin D replacement therapy in persons with spinal cord injury

Bauman, William A.; Emmons, Racine R.; Cirnigliaro, Christopher M.; Kirshblum, Steven; Spungen, Ann M.

doi:10.1179/2045772311y.0000000032

Cited by 34 publications

(33 citation statements)

References 42 publications

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“…It's important to emphasize that this study was performed in a subtropical region, what could contribute with the low vitamin D levels. This finding is similar to the data published by Bauman et al [17] that also evaluated subjects with SCI. These authors detected a mean concentration of vitamin D of 14 ng/mL in the assessed group.…”

Section: Discussionsupporting

confidence: 92%

“…This finding is probably related to the shorter time of sun exposure due to limited mobility. SCI is a complex condition that leads to biopsychosocial and lifestyle changes [15,17]. This low solar exposure in patients with SCI could be related with longstanding hospitalization, immobilization, as well as the lack of financial conditions, which entails the impossibility of hiring a professional who could assist the patient's locomotion, in order to increase the time of sun exposition [18].…”

Section: Discussionmentioning

confidence: 99%

“…The suppression of the PTH-vitamin D axis is due to prolonged immobilization, when a process of accelerated bone demineralization occurs, increasing the calcemia and consequently reducing the secretion of PTH and conversion of the bioactive portion of vitamin D [17]. However, Karapolat et al [8] highlight that in the acute period after the injury there is suppression of the PTH-vitamin D axis, while during the chronic phase, a reverse activity of PTH can be observed.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Factors related to decreased vitamin D levels in men with spinal cord injury living in a subtropical region

Bassuino¹,

Kaminski²,

Garcia³

et al. 2018

Sci Med

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors related to decreased vitamin D levels in men with spinal cord injury living in a subtropical region

Bassuino¹,

Kaminski²,

Garcia³

et al. 2018

Sci Med

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“…Only a few other studies investigated the effect of vitamin D supplementation on vitamin D status in individuals with a spinal cord injury [27,38,39]. Most of these studies failed to achieve a sufficient vitamin D status after the supplementation period [39,40].…”

Section: Discussionmentioning

confidence: 99%

Effect of 12-Week Vitamin D Supplementation on 25[OH]D Status and Performance in Athletes with a Spinal Cord Injury

2016

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(1) Background: studies with able-bodied athletes showed that performance might possibly be influenced by vitamin D status. Vitamin D seems to have a direct impact on neuromuscular function by docking on vitamin D receptors in the muscle tissue. Additionally, a high prevalence of vitamin D deficiency was shown not only in infants and in the elderly but also in healthy adults and spinal cord injured individuals. Therefore, the aim of our study was to investigate whether a vitamin D dose of 6000 IU daily over 12 weeks would be sufficient to increase vitamin D status in indoor wheelchair athletes to a normal or optimal vitamin D level and whether vitamin D deficiency is associated with an impairment in muscle performance in these individuals; (2) Methods: vitamin D status was assessed in indoor elite wheelchair athletes in order to have a baseline measurement. If vitamin D status was below 75 nmol/L, athletes were supplemented with 6000 IU of vitamin D daily over 12 weeks. A vitamin D status over 75 nmol/L was supplemented with a placebo supplement. Vitamin D status, as well as a Wingate test and an isokinetic dynamometer test, were performed at baseline and after six and 12 weeks; (3) Results: 20 indoor elite wheelchair athletes participated in this double-blind study. All of these athletes showed an insufficient vitamin D status at baseline and were, therefore, supplemented with vitamin D. All athletes increased vitamin D status significantly over 12 weeks and reached an optimal level. Wingate performance was not significantly increased. Isokinetic dynamometer strength was significantly increased but only in the non-dominant arm in isometric and concentric elbow flexion; (4) Conclusion: a dose of 6000 IU of vitamin D daily over a duration of 12 weeks seems to be sufficient to increase vitamin D status to an optimal level in indoor wheelchair athletes. It remains unclear, whether upper body performance or muscle strength and vitamin D status are associated with each other.

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“…The ability of patients in rehabilitation to go outdoors and obtain vitamin D from sun exposure is often limited due to decreased functional mobility and hospitalization . In looking toward decreasing these risks, previous studies demonstrated that vitamin D supplementation reduced the rate of vitamin D deficiency in patients undergoing rehabiliation . Despite the evidence of widespread VDD and VDI in rehabilitation patients and the effectiveness of vitamin D supplementation in increasing serum levels, there is limited literature regarding effective interventions to increase screening and supplementation in the acute inpatient rehabilitation setting.…”

Section: Introductionmentioning

confidence: 99%

Intervention for Increasing Vitamin D Supplementation in a Deficient Rehabilitation Population: Outcomes of a Quality Improvement Initiative

Krull

Abramoff

Jerome

et al. 2019

PM&R

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Background Vitamin D deficiency (VDD) is highly prevalent and increases the risk of osteoporosis, falls, and fractures. Patients in acute inpatient rehabilitation have several risk factors for VDD, the adverse effects of which may hinder long‐term functional gain. Objective To evaluate the prevalence of and risk factors for VDD in patients admitted to acute inpatient rehabilitation and to evaluate the efficacy of a standardized vitamin D screening and supplementation protocol. Design Prospective cohort study as part of a quality improvement initiative. Setting An academic, freestanding acute inpatient rehabilitation hospital. Participants Patients consecutively admitted over a 4‐month period between November 2014 and February 2015 (n=128 pre‐intervention and n=129 post‐intervention). Intervention Universal screening of vitamin D level on admission followed by utilization of a standard supplementation protocol. Main Outcome Measures Vitamin D insufficiency (VDI) and VDD prevalence along with screening, and supplementation rates. Results Preintervention, 10.2% of patients were screened for VDD, with 23.1% VDI and 46.2% VDD. Postintervention, 89.9% were screened, with 31.9% VDI and 47.4% VDD. 6.3% of all patients were supplemented on vitamin D preintervention compared to 53.5% postintervention. In multivariate analyses, the odds of VDD was significantly associated with African American race (OR 7.30, 95% CI, 1.56‐34.20, P = .12) and age younger than 65 (OR 13.62 95% CI, 2.51‐73.83, P = .002). Diagnoses in the “other neurologic” category were associated with decreased odds of VDD (OR 0.01, 95% CI, 0.001‐0.193, P = .002). Conclusions Given the high prevalence of VDD in an acute inpatient rehabilitation hospital, a routine screening and standardized supplementation protocol may improve quality of care. Level of Evidence III

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An effective oral vitamin D replacement therapy in persons with spinal cord injury

Cited by 34 publications

References 42 publications

Factors related to decreased vitamin D levels in men with spinal cord injury living in a subtropical region

Factors related to decreased vitamin D levels in men with spinal cord injury living in a subtropical region

Effect of 12-Week Vitamin D Supplementation on 25[OH]D Status and Performance in Athletes with a Spinal Cord Injury

Intervention for Increasing Vitamin D Supplementation in a Deficient Rehabilitation Population: Outcomes of a Quality Improvement Initiative

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