Active-resisted Stance Modulates Regional Bone Mineral Density in Humans with Spinal Cord Injury

Overview

Journal J Spinal Cord Med

Date 2013 Jul 2

PMID 23809588

Citations 14

Authors

Shauna Dudley-Javoroski

Richard K Shields

Affiliations

Soon will be listed here.

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.

Citing Articles

Effect of Adapted Ergometer Setup and Rowing Speed on Lower Extremity Loading in People with and Without Spinal Cord Injury.

Fang Y, Troy K Bioengineering (Basel). 2025; 12(1.

PMID: 39851349 PMC: 11761565. DOI: 10.3390/bioengineering12010075.

Low-frequency electrically induced exercise after spinal cord injury: Physiologic challenge to skeletal muscle and feasibility for long-term use.

Petrie M, Dudley-Javoroski S, Johnson K, Lee J, Dubey O, Shields R J Spinal Cord Med. 2024; 47(6):1026-1032.

PMID: 38619192 PMC: 11533229. DOI: 10.1080/10790268.2024.2338295.

The Effects of Exercise and Activity-Based Physical Therapy on Bone after Spinal Cord Injury.

Sutor T, Kura J, Mattingly A, Otzel D, Yarrow J Int J Mol Sci. 2022; 23(2).

PMID: 35054791 PMC: 8775843. DOI: 10.3390/ijms23020608.

Osteoporosis after spinal cord injury: aetiology, effects and therapeutic approaches.

Abdelrahman S, Ireland A, Winter E, Purcell M, Coupaud S J Musculoskelet Neuronal Interact. 2021; 21(1):26-50.

PMID: 33657753 PMC: 8020025.

Functional electrical stimulation (FES)-assisted rowing combined with zoledronic acid, but not alone, preserves distal femur strength and stiffness in people with chronic spinal cord injury.

Fang Y, Morse L, Nguyen N, Battaglino R, Goldstein R, Troy K Osteoporos Int. 2020; 32(3):549-558.

PMID: 32888047 DOI: 10.1007/s00198-020-05610-x.

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