Spinal Cord Injury as a Model of Bone-Muscle Interactions: Therapeutic Implications From in vitro and in vivo Studies

Frontiers in Endocrinology, 2020 · DOI: 10.3389/fendo.2020.00204 · Published: April 15, 2020

Spinal Cord Injury Endocrinology Rehabilitation

Simple Explanation

Spinal cord injuries (SCIs) can cause problems with both bones and muscles. This review looks at treatments for bone and muscle issues after SCI. Medicines like bisphosphonates and exercise can help with bone loss and muscle weakness. More research is needed to find the best ways to treat these problems. Treating both bone and muscle together may be the best approach. Exercise, nutrition, and electrical stimulation are promising ways to treat both issues.

Study Duration

Not specified

Participants

Animal models and human subjects

Evidence Level

Review article

Key Findings

1
Bisphosphonates, anti-sclerostin monoclonal antibodies, hydrogen sulfide, parathyroid hormone, and RANKL pathway inhibitors are valuable options for treating bone alterations after SCI.
2
Testosterone, anabolic-androgenic steroids, and selective androgen receptor modulators can counteract muscle loss after SCI.
3
Exercise and physical therapy increase bone and muscle mass after SCI. Nutritional interventions could enhance SCI treatment.

Research Summary

This review comprehensively characterizes available treatment options targeting the skeleton and bone in the setting of SCI. Pharmacological interventions such as bisphosphonates and anti-sclerostin monoclonal antibodies are valuable for treating bone alterations, while testosterone and anabolic-androgenic steroids can counteract muscle loss. Exercise, physical therapy, and nutritional interventions enhance SCI treatment, but multidisciplinary recommendations are required for proper clinical management.

Practical Implications

Pharmacological Treatment

Several drugs, including bisphosphonates and testosterone, can be used to treat bone and muscle loss after SCI.

Exercise and Physical Therapy

Exercise and physical therapy are important strategies to increase bone and muscle mass after SCI.

Multidisciplinary Approach

A combination of different interventions is needed to optimize outcomes at the bone and muscle level in SCI patients.

Study Limitations

1
Small sample sizes in clinical trials assessing bisphosphonates.
2
Lack of robust evidence about local pharmacological agents to counteract muscle loss after SCI.
3
Scarcity of nutritional guidelines for SCI patients.

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