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  4. Barriers to Providing Dual Energy X-ray Absorptiometry Services to Individuals with Spinal Cord Injury

Barriers to Providing Dual Energy X-ray Absorptiometry Services to Individuals with Spinal Cord Injury

Am J Phys Med Rehabil, 2009 · DOI: 10.1097/PHM.0b013e31818a5f87 · Published: January 1, 2009

Spinal Cord InjuryMusculoskeletal Medicine

Simple Explanation

This study investigates obstacles in performing bone density scans (DXA) on people with spinal cord injuries (SCI). These scans are important because SCI can lead to bone loss and fractures. The research identifies issues like the design of scanning machines, room size, and staffing levels that make it difficult for individuals with SCI to undergo routine bone mineral density assessments. The authors suggest changes such as installing lifts, increasing staff during scans, and raising awareness to make DXA scanning more accessible for those with SCI.

Study Duration
Not specified
Participants
20 individuals with spinal cord injury
Evidence Level
Cross-sectional study

Key Findings

  • 1
    Scanner design and configuration in the scanning room limited accessibility, increased typical scanning time, and made additional staff necessary.
  • 2
    The height differential between a typical wheelchair seat and the DXA scan table is too great for standard sliding board transfers.
  • 3
    Room size limited entry and maneuverability of stretchers, wheelchairs, and hoyer lifts.

Research Summary

This study identified several physical and logistical barriers to DXA scanning for individuals with SCI, including scanner design, room size, and staffing requirements. The process of DXA scanning is not well designed for accessibility, and no bone densitometer model was easily adaptable for that purpose. The authors recommend specific changes to facilitate DXA scanning for SCI patients, such as installing lifts and grab bars, increasing staffing, and raising awareness of access issues.

Practical Implications

Improved Accessibility

Implementing recommended changes (lifts, grab bars, adequate room size) can significantly improve accessibility to DXA scanning for individuals with SCI.

Standard of Care

Addressing these barriers may help in making bone density assessment a standard of care following SCI, leading to better management of osteoporosis and fracture risk.

Broader Application

The identified issues may be applicable to other patient populations with mobility limitations, such as stroke patients and lower extremity amputees, thus improving healthcare access for a wider range of individuals.

Study Limitations

  • 1
    Small sample size (20 participants)
  • 2
    Cross-sectional study design
  • 3
    Focus on veterans treated at a single VA Medical Center

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