R S Gibbons1, I D McCarthy2, A Gall3, C G Stock1, J Shippen4, B J Andrews5. 1. Centre for Sports Medicine and Human Performance, Brunel University, London, UK. 2. UCL Institute of Orthopaedics and Musculoskeletal Science, Stanmore, UK. 3. 1] UCL Institute of Orthopaedics and Musculoskeletal Science, Stanmore, UK [2] London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, Stanmore, UK. 4. Department of Industrial Design, Coventry University, Coventry, UK. 5. Nuffield Department of Surgical Sciences, Oxford University, Oxford, UK.
Abstract
STUDY DESIGN: A single case study. OBJECTIVES: To compare proximal tibia trabecular bone mineral density (BMD) of a participant with complete spinal cord injury (SCI), long-termed functional electrical stimulation-rowing (FES-R) trained, with previously reported SCI and non-SCI group norms. To estimate lower limb joint contact forces (JCFs) in the FES-R trained participant. SETTING: UK University and orthopaedic hospital research centre. METHODS: Bilateral proximal tibial trabecular BMD of the FES-R trained participant was measured using peripheral quantitative computerised tomography, and the data were compared with SCI and non-SCI groups. An instrumented four-channel FES-R system was used to measure the lower limb JCFs in the FES-R trained participant. RESULTS: Structurally, proximal tibial trabecular BMD was higher in the FES-R trained participant compared with the SCI group, but was less than the non-SCI group. Furthermore, left (184.7 mg cm(-3)) and right (160.7 mg cm(-3)) BMD were well above the threshold associated with non-traumatic fracture. The knee JCFs were above the threshold known to mediate BMD in SCI, but below threshold at the hip and ankle. CONCLUSION: As pathological fractures predominate in the distal femur and proximal tibia in chronic SCI patients, the fact that the FES-R trained participant's knee JCFs were above those known to partially prevent bone loss, suggests that FES-R training may provide therapeutic benefit. Although the elevated bilateral proximal tibial BMD of the FES-R participant provides circumstantial evidence of osteogenesis, this single case precludes any statement on the clinical significance. Further investigations are required involving larger numbers and additional channels of FES to increase loading at the hip and ankle.
STUDY DESIGN: A single case study. OBJECTIVES: To compare proximal tibia trabecular bone mineral density (BMD) of a participant with complete spinal cord injury (SCI), long-termed functional electrical stimulation-rowing (FES-R) trained, with previously reported SCI and non-SCI group norms. To estimate lower limb joint contact forces (JCFs) in the FES-R trained participant. SETTING: UK University and orthopaedic hospital research centre. METHODS: Bilateral proximal tibial trabecular BMD of the FES-R trained participant was measured using peripheral quantitative computerised tomography, and the data were compared with SCI and non-SCI groups. An instrumented four-channel FES-R system was used to measure the lower limb JCFs in the FES-R trained participant. RESULTS: Structurally, proximal tibial trabecular BMD was higher in the FES-R trained participant compared with the SCI group, but was less than the non-SCI group. Furthermore, left (184.7 mg cm(-3)) and right (160.7 mg cm(-3)) BMD were well above the threshold associated with non-traumatic fracture. The knee JCFs were above the threshold known to mediate BMD in SCI, but below threshold at the hip and ankle. CONCLUSION: As pathological fractures predominate in the distal femur and proximal tibia in chronic SCI patients, the fact that the FES-R trained participant's knee JCFs were above those known to partially prevent bone loss, suggests that FES-R training may provide therapeutic benefit. Although the elevated bilateral proximal tibial BMD of the FES-Rparticipant provides circumstantial evidence of osteogenesis, this single case precludes any statement on the clinical significance. Further investigations are required involving larger numbers and additional channels of FES to increase loading at the hip and ankle.
Authors: Rebecca L Lambach; Nicole E Stafford; Julie A Kolesar; B Jenny Kiratli; Graham H Creasey; Robin S Gibbons; Brian J Andrews; Gary S Beaupre Journal: J Spinal Cord Med Date: 2018-11-26 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