Rebecca L Lambach1,2, Nicole E Stafford3, Julie A Kolesar1,4, B Jenny Kiratli1, Graham H Creasey1,2, Robin S Gibbons5, Brian J Andrews6,7, Gary S Beaupre1,4. 1. Spinal Cord Injury & Disorders Center, VA Palo Alto Health Care System, Palo Alto, California, USA. 2. Department of Neurosurgery, Stanford University, Stanford, California, USA. 3. Department of Mechanical Engineering, Stanford University, Stanford, California, USA. 4. Bioengineering Department, Stanford University, Stanford, California, USA. 5. Aspire CREATe Centre for Rehabilitation Engineering and Assistive Technology, Division of Surgery & International Science, Royal National Orthopaedic Hospital, University College London, Stanmore, UK. 6. School of Engineering, University of Warwick, Coventry, UK. 7. Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.
Abstract
Objective: To determine the effect of a functional electrical stimulation (FES) rowing program on bone mineral density (BMD) when implemented within two years after SCI.Design: Prospective.Setting: Health Care Facility.Participants: Convenience sample; four adults with recent (<2 years) traumatic, motor complete SCI (C7-T12 AIS A-B).Intervention: A 90-session FES rowing exercise program; participants attended 30-minute FES training sessions approximately three times each week for the duration of their participation.Outcome Measures: BMD in the distal femur and tibia were measured using peripheral Quantitative Computed Tomography (pQCT) at enrollment (T0) and after 30 (T1), 60 (T2), and 90 (T3) sessions. Bone stimulus was calculated for each rower at each time point using the average number of weekly loading cycles, peak foot reaction force, and bone mineral content from the previous time point. A regression analysis was used to determine the relationship between calculated bone stimulus and change in femoral trabecular BMD between time points. Results: Trabecular BMD in the femur and tibia decreased for all participants in T0-1, but the rate of loss slowed or reversed between T1-2, with little-to-no bone loss for most participants during T2-3. The calculated bone stimulus was significantly correlated with change in femoral trabecular BMD (P = 0.016; R2 = 0.458). Conclusion: Consistent participation in an FES rowing program provides sufficient forces and loading cycles to reduce or reverse expected bone loss at the distal femur and tibia, at least temporarily, in some individuals within two years after SCI.Trial Registration: NCT02008149.
Objective: To determine the effect of a functional electrical stimulation (FES) rowing program on bone mineral density (BMD) when implemented within two years after SCI.Design: Prospective.Setting: Health Care Facility.Participants: Convenience sample; four adults with recent (<2 years) traumatic, motor complete SCI (C7-T12 AIS A-B).Intervention: A 90-session FES rowing exercise program; participants attended 30-minute FES training sessions approximately three times each week for the duration of their participation.Outcome Measures: BMD in the distal femur and tibia were measured using peripheral Quantitative Computed Tomography (pQCT) at enrollment (T0) and after 30 (T1), 60 (T2), and 90 (T3) sessions. Bone stimulus was calculated for each rower at each time point using the average number of weekly loading cycles, peak foot reaction force, and bone mineral content from the previous time point. A regression analysis was used to determine the relationship between calculated bone stimulus and change in femoral trabecular BMD between time points. Results: Trabecular BMD in the femur and tibia decreased for all participants in T0-1, but the rate of loss slowed or reversed between T1-2, with little-to-no bone loss for most participants during T2-3. The calculated bone stimulus was significantly correlated with change in femoral trabecular BMD (P = 0.016; R2 = 0.458). Conclusion: Consistent participation in an FES rowing program provides sufficient forces and loading cycles to reduce or reverse expected bone loss at the distal femur and tibia, at least temporarily, in some individuals within two years after SCI.Trial Registration: NCT02008149.
Authors: W Brent Edwards; Narina Simonian; Ifaz T Haider; Alan S Anschel; David Chen; Keith E Gordon; Elaine K Gregory; Ki H Kim; Ramadevi Parachuri; Karen L Troy; Thomas J Schnitzer Journal: J Bone Miner Res Date: 2018-06-28 Impact factor: 6.741
Authors: L R Morse; R A Battaglino; K L Stolzmann; L D Hallett; A Waddimba; D Gagnon; A A Lazzari; E Garshick Journal: Osteoporos Int Date: 2008-06-26 Impact factor: 4.507
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