DEXA: a practical and accurate tool to demonstrate total and regional bone loss, lean tissue loss and fat mass gain in paraplegia

Jones, Lynnette M.; Goulding, Ailsa; Gerrard, David

doi:10.1038/sj.sc.3100664

Cited by 91 publications

(81 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, there are a few factors which may explain the lack of significant changes in FFM seen in the present study. Although DXA has been reported 44 to provide an accurate measure of body composition in SCI, its sensitivity towards detecting small changes in FM or FFM is surpassed by magnetic resonance imaging (MRI). For example, MRI-determined mean CSA of visceral adipose tissue was reduced by 25%, and quadriceps muscle mass increased by 25-30%, in response to resistance training compared to no significant changes in estimates of whole-body FFM or FM/%BF determined by DXA.…”

Section: Discussionmentioning

confidence: 99%

Chronic activity-based therapy does not improve body composition, insulin-like growth factor-I, adiponectin, or myostatin in persons with spinal cord injury

Astorino

Harness

Witzke

2014

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

Spinal cord injury (SCI) induces dramatic changes in body composition including reductions in fat-free mass (FFM) and increases in fat mass (FM). Objective: To examine changes in body composition in response to chronic activity-based therapy (ABT) in persons with SCI. Design: Longitudinal exercise intervention. Methods: Seventeen men and women with SCI (mean age = 36.1 ± 11.5 years) completed 6 months of supervised ABT consisting of load bearing, resistance training, locomotor training, and functional electrical stimulation. At baseline and after 3 and 6 months of ABT, body weight, body fat, and FFM were assessed using dual-energy X-ray absorptiometry, and fasting blood samples were obtained to assess changes in insulin-like growth factor-I (IGF-I), adiponectin, and myostatin. Results: Across all subjects, there was no change (P > 0.05) in body weight, percent body fat, or FFM of the leg, arm, or trunk, whereas whole-body FFM declined (P = 0.02, 50.4 ± 8.4 to 49.2 ± 7.4 kg). No changes (P = 0.21-0.41) were demonstrated in IGF-I, adiponectin, or myostatin during the study. Conclusions: Chronic ABT focusing on the lower extremity does not slow muscle atrophy or alter body fat, body mass, or regional depots of FFM in persons with SCI. Further, it does not induce beneficial changes in adiponectin, myostatin, or IGF-I. Alternative exercise-based therapies are needed in SCI to reverse muscle atrophy and minimize the onset of related health risks.

show abstract

Section: Discussionmentioning

confidence: 99%

Chronic activity-based therapy does not improve body composition, insulin-like growth factor-I, adiponectin, or myostatin in persons with spinal cord injury

Astorino

Harness

Witzke

2014

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

show abstract

“…As bone complications, for example, heterotopic ossification, scoliosis, osteomyelitis, arthroses, internal fixation of bone, can influence DEXA precision, 28,29 International Society for Clinical Densitometry (ISCD) scan artefact criteria were applied and scans were extracted accordingly (periarticular hip artefact n ¼ 5, two FES, three CON). Percentage change (%) BMD was derived from baseline BMD (g/cm 2 ) and % fat mass (FM) from total body mass (g).…”

Section: Analysesmentioning

confidence: 99%

Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss

Clark

Jelbart

Rischbieth³

et al. 2006

Spinal Cord

View full text Add to dashboard Cite

Study design: Controlled, repeat-measures study. Objectives: To determine if functional electrical stimulation (FES) can affect bone atrophy in early spinal cord injury (SCI), and the safety, tolerance and feasibility of this modality in bone loss remediation. Setting: Spinal Injuries Units, Royal Adelaide Hospital and Hampstead Rehabilitation Centre, South Australia. Methods: Patients with acute SCI (ASIA A-D) were allocated to FES (n ¼ 23, 2879 years, C4-T10, 13 Tetra) and control groups (CON, n ¼ 10, 31711 years, C5-T12, four Tetra). The intervention group received discontinuous FES to lower limb muscles (15 min sessions to each leg twice daily, over a 5-day week, for 5 months). Dual energy X-ray absorptiometry (DEXA) measured total body bone mineral density (tbBMD), hip, spine BMD and fat mass (FM) within 3 weeks, and 3 and 6 months postinjury. Results: FES and CON groups' tbBMD differed significantly at 3 months postinjury (Po0.01), but not thereafter. Other DEXA measures (hip, spine BMD, FM) did not differ between groups at any time. No adverse events were identified. Conclusion: Electrically stimulated muscle activation was elicited, and tetanic effects were reproducible; however, there were no convincing trends to suggest that FES can play a clinically relevant role in osteoporosis prevention (or subsequent fracture risk) in the recently injured patient. The lack of an osteogenic response in paralysed extremities to electrically evoked exercise during subacute and rehabilitation/recovery phases cannot be fully explained, and may warrant further evaluation.Spinal Cord (2007) 45, 78-85.

show abstract

“…They suggested the need for further research on speci®c dietary and exercise interventions to maintain or improve lean tissue mass and bone mineral content among individuals with SCI, while reducing body fat accumulation. 37 Proportional UE lean body mass increases which maintain an adequate strength:mass ratio, and reduced body fat levels would improve UE muscular e ciency during transfers, thereby reducing UE degenerative forces from excessive loading and preserving UE function.…”

Section: Introductionmentioning

confidence: 99%

Preserving transfer independence among individuals with spinal cord injury

et al. 2000

View full text Add to dashboard Cite

Study design: Literature review. Objectives: Upper extremity (UE) joint degeneration, particularly at the shoulder, detrimentally in¯uences functional independence, quality of life, cardiovascular disease risk, and life expectancy of individuals following spinal cord injury (SCI). This review (1) describes UE use for transfers among individuals with SCI; (2) describes contributing factors associated with UE joint degeneration and loss of transfer independence; (3) summarizes and identi®es gaps in existing research; and (4) provides suggestions for future research. Results: Investigations of wheelchair transfer related UE joint and function preservation among individuals with SCI should consider factors including age and length of time from SCI onset, interface between subject-wheelchair, pain, shoulder joint range of motion (ROM) and muscle strength de®ciencies or imbalances, exercise capacity and tolerance for the physical strain of activities of daily living (ADL), body mass and composition, previous UE injury or disease history, and transfer techniques. Existing studies of transfers among individuals with SCI have relied on small groups of either asymptomatic or non-impaired subjects, with minimal integration of kinematic, kinetic and electromyographic data. Descriptions of UE joint ROM, forces, and moments produced during transfers are lacking. Conclusions: Biomechanical measurement and computer modeling have provided increasingly accurate tools for acquiring the data needed to guide intervention planning to prevent UE joint degeneration and preserve function among individuals with SCI. The identi®cation of stressful sub-components during transfers will enable intervening clinicians and engineers who design and modify assistive and adaptive devices to better serve individuals with SCI. Spinal Cord (2000) 38, 649 ± 657

show abstract

DEXA: a practical and accurate tool to demonstrate total and regional bone loss, lean tissue loss and fat mass gain in paraplegia

Cited by 91 publications

References 27 publications

Chronic activity-based therapy does not improve body composition, insulin-like growth factor-I, adiponectin, or myostatin in persons with spinal cord injury

Chronic activity-based therapy does not improve body composition, insulin-like growth factor-I, adiponectin, or myostatin in persons with spinal cord injury

Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss

Preserving transfer independence among individuals with spinal cord injury

Contact Info

Product

Resources

About