Shauna Dudley-Javoroski1, Richard K Shields. 1. Department of Physical Therapy & Rdhabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
Abstract
OBJECTIVE: In people with spinal cord injury (SCI), active-resisted stance using electrical stimulation of the quadriceps delivered a therapeutic stress to the femur (∼150% of body weight) and attenuated bone mineral density (BMD) decline. In standard densitometry protocols, BMD is averaged over the entire bone cross-section. An asymmetric adaptation to mechanical load may be masked by non-responding regions. The purpose of this study was to test a novel method to assess regional BMD of the femur in individuals with SCI. We hypothesize that there will be regional bone-sparing changes as a result of active-resisted stance. DESIGN: Mixed cross-sectional and longitudinal. SETTING: Research laboratory. PARTICIPANTS: Twelve individuals with SCI and twelve non-SCI controls. INTERVENTION: Individuals with SCI experienced active-resisted stance or passive stance for up to 3 years. OUTCOME MEASURES: Peripheral quantitative computed tomography images from were partitioned so that femur anatomic quadrants could be separately analyzed. RESULTS: Over 1.5 years, the slope of BMD decline over time was slower at all quadrants for the active-resisted stance limbs. At >2 years of training, BMD was significantly higher for the active-resisted stance group than for the passive stance group (P = 0.007). BMD was preferentially spared in the posterior quadrants of the femur with active-resisted stance. CONCLUSIONS: A regional measurement technique revealed asymmetric femur BMD changes between passive stance and active-resisted stance. Future studies are now underway to better understand other regional changes in BMD after SCI.
OBJECTIVE: In people with spinal cord injury (SCI), active-resisted stance using electrical stimulation of the quadriceps delivered a therapeutic stress to the femur (∼150% of body weight) and attenuated bone mineral density (BMD) decline. In standard densitometry protocols, BMD is averaged over the entire bone cross-section. An asymmetric adaptation to mechanical load may be masked by non-responding regions. The purpose of this study was to test a novel method to assess regional BMD of the femur in individuals with SCI. We hypothesize that there will be regional bone-sparing changes as a result of active-resisted stance. DESIGN: Mixed cross-sectional and longitudinal. SETTING: Research laboratory. PARTICIPANTS: Twelve individuals with SCI and twelve non-SCI controls. INTERVENTION: Individuals with SCI experienced active-resisted stance or passive stance for up to 3 years. OUTCOME MEASURES: Peripheral quantitative computed tomography images from were partitioned so that femur anatomic quadrants could be separately analyzed. RESULTS: Over 1.5 years, the slope of BMD decline over time was slower at all quadrants for the active-resisted stance limbs. At >2 years of training, BMD was significantly higher for the active-resisted stance group than for the passive stance group (P = 0.007). BMD was preferentially spared in the posterior quadrants of the femur with active-resisted stance. CONCLUSIONS: A regional measurement technique revealed asymmetric femur BMD changes between passive stance and active-resisted stance. Future studies are now underway to better understand other regional changes in BMD after SCI.
Authors: B M Needham-Shropshire; J G Broton; K J Klose; N Lebwohl; R S Guest; P L Jacobs Journal: Arch Phys Med Rehabil Date: 1997-08 Impact factor: 3.966
Authors: C M Cirnigliaro; M J Myslinski; M F La Fountaine; S C Kirshblum; G F Forrest; W A Bauman Journal: Osteoporos Int Date: 2016-12-05 Impact factor: 4.507
Authors: Shauna Dudley-Javoroski; Ryan Amelon; Yinxiao Liu; Punam K Saha; Richard K Shields Journal: J Spinal Cord Med Date: 2013-11-11 Impact factor: 1.985
Authors: Nour Zleik; Frances Weaver; Robert L Harmon; Brian Le; Reshmitha Radhakrishnan; Wanda D Jirau-Rosaly; B Catharine Craven; Mattie Raiford; Jennifer N Hill; Bella Etingen; Marylou Guihan; Michael H Heggeness; Cara Ray; Laura Carbone Journal: J Spinal Cord Med Date: 2018-05-10 Impact factor: 1.985