Does Standing Protect Bone Density in Patients With Chronic Spinal Cord Injury?

Göktepe, Ahmet Salim; Tuğcu, İlknur; Yılmaz, Bilge; Alaca, Rıdvan; Gündüz, Şükrü

doi:10.1080/10790268.2008.11760712

Cited by 31 publications

(13 citation statements)

References 20 publications

(13 reference statements)

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“…Most studies have failed to find an effect of various exercise loading protocols on leg bone in SCI . However, our results support the few previous studies that found high exercise volume (magnitude × frequency) effective in improving bone health.…”

Section: Discussionsupporting

confidence: 78%

“…Bone remodels continuously in response to applied stresses and strains, and these adaptations are central to maintain bone mass and ensure sufficient bone strength. However, interventions that load sublesional bone in SCI (eg, standing frame, body‐weight‐supported treadmill walking, functional electrical stimulation‐ [FES‐] cycling) have rarely been shown to have even a modest effect, if any effect at all . This could be because of insufficient loading intensity (magnitude, number of cycles, and duration) to promote changes in bone density.…”

Section: Introductionmentioning

confidence: 99%

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Effects of FES‐Rowing Exercise on the Time‐Dependent Changes in Bone Microarchitecture After Spinal Cord Injury: A Cross‐Sectional Investigation

et al. 2019

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Disuse osteoporosis is a serious, secondary consequence of spinal cord injury (SCI). Numerous pharmacological and exercise therapies have been implemented to mitigate bone loss after SCI. However, these therapies have not been shown to improve bone density, potentially because of insufficient duration and magnitude of loading and/or inability of imaging modalities to capture changes in bone microarchitecture. In this cross-sectional study, we evaluated bone microstructure of the distal tibia and radius using HR-pQCT in men with SCI (N = 13) who regularly trained with functional electrical stimulation-(FES-) rowing. We aimed to determine whether the amount of FES-rowing (total distance rowed and peak foot force) and/or time since injury (TSI) predict bone loss after SCI. We assessed volumetric density of the total, cortical, and trabecular compartments, cortical thickness, and trabecular thickness. Using linear regression analysis, we found that TSI was not associated with any of the tibial bone metrics. In fact, none of the variables (TSI, total distance rowed, and peak foot force) independently predicted bone loss. Using stepwise regression, when all three variables were considered together, we found a strong prediction for trabecular microstructure (trabecular vBMD: R 2 = 0.53; p = 0.06; trabecular thickness: R 2 = 0.72; p < 0.01), but not cortical bone metrics. In particular, trabecular vBMD and thickness were negatively associated with TSI and positively associated with distance rowed. Foot force contributed markedly less to trabecular bone than distance rowed or TSI. Our results suggest that regular FES-rowing may have the capacity to alter the time-dependent bone negative effects of SCI on trabecular bone density and microstructure.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Effects of FES‐Rowing Exercise on the Time‐Dependent Changes in Bone Microarchitecture After Spinal Cord Injury: A Cross‐Sectional Investigation

et al. 2019

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“…21 Moreover, in chronic SCI patients, daily standing (41 h) showed no significant change in mean t-score of the proximal femur region. 32 In acute SCI patients (8-12 weeks after SCI), however, passive standing (41 h) was capable of preserving bone mass and improving BMD as compared with those of non-standing patients (42 years after SCI). 33 Thus, the mechanical loading interventions, such as vibration or weight-bearing, during the early stage of SCI appear potent for preventing bone loss and maintaining bone mass.…”

Section: Effects Of Vibration Stimulus On Bone In Sci Ratsmentioning

confidence: 94%

Whole-body vibration can attenuate the deterioration of bone mass and trabecular bone microstructure in rats with spinal cord injury

et al. 2015

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Study design: Experimental, controlled study. Objective: To examine the effects of whole-body vibration (WBV) on bone mass and trabecular bone microstructure (TBMS) during the early stage in juvenile rats with spinal cord injury (SCI). Setting: Studied at the Kio University in Japan. Methods: Thirty-four 8-week-old male Wistar rats were divided into 3 groups: the SCI group, the sham-operation group (SHAM) and the SCI+WBV group. WBV started on the 8th day after SCI. After 1 or 2 weeks of WBV treatment, measurements of tissue mineral density, trabecular bone mineral content (BMC) and parameters of TBMS were obtained by scanning the proximal tibias with x-ray micro-computed tomography. Serum levels of osteocalcin (OC) and of tartrate-resistant acid phosphatase 5b (TRACP 5b) were measured with ELISA. Results: BMC, volume bone mineral density, bone volume (BV), BV fraction (BV/tissue volume) and connectivity density (Conn.D) of TBMS parameters were significantly higher in SCI+WBV rats than in SCI rats after 2-week WBV. The BMC and BV/TV of bone mass index correlated well with Conn.D, suggesting the preservation of Conn.D. induced by WBV. SCI+WBV rats showed a decrease in serum OC after 1-week WBV, but a quick recovery from that after 2-week WBV. There was no difference in serum TRACP 5b among the 3 groups throughout the experimental period. Conclusion: WBV treatment could attenuate the bone deterioration that occurs during the early stage in juvenile rats with SCI. In a clinic, this early WBV intervention may be an effective rehabilitation modality for preventing bone fragility in SCI patients. Spinal Cord (2016) 54, 597-603; doi:10.1038/sc.2015.220; published online 22 December 2015 INTRODUCTION Osteoporosis is a well-known complication of spinal cord injury (SCI).The mechanism of bone loss by SCI is complex and is constituted by multiple factors involving mechanical, neurovascular, hormonal and metabolic factors. 1,2 Bone loss following SCI begins within the first 6 months after the injury, and stabilizes between 12 and 16 months. 3 Bone loss is especially prominent in sublesional bones such as the distal femur and proximal tibia. [4][5][6][7][8] In fact, bone mass in the distal femur and proximal tibia decreased by 51% and 70%, respectively, within 1 year after the injury in SCI patients. 6 These two bones were so fragile that even a weak physical impact could cause a fracture in SCI patients. 7,8 Therefore, the frequency of fracture in SCI patients was about twice as high as that of healthy people. 9 Edwards et al. 10 showed that in the femur and tibia of acute SCI patients trabecular bone mineral content (BMC) was reduced by 3.1-4.4% per month and volumetric bone mineral density (BMD) by 2.7-4.7% per month within 4 months after the injury. In addition, cortical BMC and volumetric BMD were noticeably reduced, and furthermore bone strength indices were decreased. 10 The incidence of SCI is higher in young people aged 15-24 years. 11 Children (aged 5-13 years) with

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“…Studien über die Effekte von nichtpharmakologischen Interventionen wie Steh-oder Gehtraining (17,(54)(55)(56), Sport (34,56,57), Vibration (58)…”

Section: Nichtpharmakologische Ansätzeunclassified

Querschnittassoziierte Osteoporose

Frotzler¹,

Moosburger²,

Kalke³

2015

Osteologie

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ZusammenfassungAls Diskussionsgrundlage liegt der Entwurf einer S1-Leitlinie zur querschnittassoziierten Osteoporose der Arbeitsgruppe Osteoporose der DMGP vor. Der Entwurf wurde u. a. in Anlehnung an die DVO-Leitlinie “Prophylaxe, Diagnostik und Therapie der Osteoporose bei Männern ab dem 60. Lebensjahr und bei postmenopausalen Frauen” erarbeitet. Die Ursache der querschnittassoziierten Osteo -porose ist multifaktoriell, die fehlende mechanische Belastung gilt als ein Hauptfaktor. Der Verlust an Knochenmineraldichte kann bereits innerhalb der ersten Monate nach Rückenmarksverletzung gemessen werden. Osteoporotisch bedingte Frakturen durch inadäquate Traumata treten bei Querschnitt -gelähmten häufig im Bereich des distalen Femurs und der proximalen Tibia auf. Es gibt nur wenige Berichte mit hoher Evidenz zur Prävention oder Therapie einer querschnitt-assoziierten Osteoporose sowie keine Hinweise darauf, inwieweit die Frakturinzidenz tatsächlich beeinflusst werden kann. Bisphosphonate scheinen die Knochenresorption bei Rückenmarksverletzten zu reduzieren. Auch gibt es Hinweise dafür, dass Funktionelle Elektrostimulation (FES) – unter gewissen Voraussetzungen – einen osteogenen Effekt auf die Knochenparameter der gelähmten Extremität besitzt. Eine DXA-Messung an LWS und einer Hüfte sollte innerhalb von sechs bis acht Wochen nach Eintritt der Querschnittlähmung erfolgen, entsprechende Kontrolluntersuchungen nach festgelegten Intervallen einseitig im Hüftbereich. Die Grundmedikation mit Kalzium und Vitamin D wird bei einem T-Score zwischen –1,0 und –2,0 empfohlen, ab –2,0 und darunter zusätzlich die Gabe von Antiresorptiva/ Osteo anabolika. Eine Therapiedauer von mindestens fünf Jahren wird für indiziert gehalten, solange der T-Score –2,0 oder geringer ist.

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Does Standing Protect Bone Density in Patients With Chronic Spinal Cord Injury?

Cited by 31 publications

References 20 publications

Effects of FES‐Rowing Exercise on the Time‐Dependent Changes in Bone Microarchitecture After Spinal Cord Injury: A Cross‐Sectional Investigation

Effects of FES‐Rowing Exercise on the Time‐Dependent Changes in Bone Microarchitecture After Spinal Cord Injury: A Cross‐Sectional Investigation

Whole-body vibration can attenuate the deterioration of bone mass and trabecular bone microstructure in rats with spinal cord injury

Querschnittassoziierte Osteoporose

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