Effect of chronic activity-based therapy on bone mineral density and bone turnover in persons with spinal cord injury

Eur J Appl Physiol, 2013 · DOI: 10.1007/s00421-013-2738-0 · Published: December 1, 2013

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

Spinal cord injury (SCI) often leads to osteoporosis, a condition where bones become weak and brittle. This study explores how activity-based therapy (ABT) affects bone health in people with SCI. The study involved participants with SCI undergoing 6 months of ABT, focusing on lower extremities. Bone mineral density (BMD) and bone turnover markers were assessed. The findings suggest that while ABT didn't fully reverse bone loss, it did slow down the expected decline in lower extremity BMD, and even improved spine BMD.

Study Duration

6 Months

Participants

13 men and women with SCI

Evidence Level

Not specified

Key Findings

1
Spine BMD significantly increased (+4.8%) after 6 months of ABT.
2
Total hip BMD significantly decreased (−6.1%) from 0 to 6 months of ABT.
3
BMD at the bilateral distal femur and proximal tibia declined but was not significantly different versus baseline.

Research Summary

This study investigated the impact of activity-based therapy (ABT) on bone mineral density (BMD) and bone turnover in individuals with spinal cord injury (SCI). The results indicated that chronic ABT did not reverse bone loss typically seen post-injury, but it did lessen the degree of BMD reduction in the lower extremities. Spine BMD showed an increase. The study suggests ABT can augment lumbar spine BMD and potentially slow bone loss in SCI patients; however, more effective strategies are needed to address osteoporosis in the lower extremities.

Practical Implications

Rehabilitation Practices

The study's data may influence rehabilitation practices for SCI patients, suggesting the incorporation of ABT to mitigate bone loss.

Future Study Design

The findings can inform the design of future studies investigating exercise as a strategy to slow osteoporosis in individuals with SCI, particularly focusing on multimodal approaches.

Therapeutic Strategies

The research underscores the need for alternative or adjunctive strategies to reverse osteoporosis in the lower extremities of SCI patients, potentially combining ABT with other interventions.

Study Limitations

1
The study had a small, heterogeneous sample of young men and women with SCI, limiting the generalizability of the findings.
2
The absence of a control group makes it difficult to definitively attribute the observed changes in BMD solely to ABT.
3
The study only lasted for 6 months, which may not be sufficient to observe long-term effects of ABT on bone health.

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