Combination Therapy With Zoledronic Acid and FES-Row Training Mitigates Bone Loss in Paralyzed Legs: Results of a Randomized Comparative Clinical Trial

This study investigates the effects of FES-rowing alone or combined with zoledronic acid (ZA) on bone health in individuals with spinal cord injury (SCI). The primary goal was to determine if the combination therapy could improve bone health more effectively than FES-rowing alone. Participants with SCI were assigned to either a 12-month FES-rowing program or a combination of FES-rowing plus a one-time dose of zoledronic acid. Bone mass and geometry changes were measured using volumetric CT scans. The study found that the combination therapy of FES-rowing and zoledronic acid helped mitigate bone loss, improving bone quality and potentially reducing fracture risk in the paralyzed lower extremities of individuals with SCI.

• 1
  Combination therapy (FES-rowing plus zoledronic acid) resulted in greater cortical bone volume (CBV) at the proximal tibial and distal femoral metaphyses compared to FES-rowing alone.
• 2
  The combination therapy also led to greater cortical thickness index (CTI) and buckling ratio (BR) at both the distal femoral and proximal tibial metaphyses in the ZA plus rowing group compared with the rowing-only group.
• 3
  A subgroup analysis of the rowing-only arm showed that gains in the compressive strength index (CSI) at the tibial metaphysis varied in a dose-dependent fashion based on the total amount of exercise performed.