US troops were deployed to the Persian Gulf in what became known as the Gulf War. Upon their return, many Gulf War veterans from both the US and other allied forces began to report chronic, unexplained fatigue, pain, Author Affiliations are listed at the end of this article. Members of the VA Cooperative Study #470 Study Group and the data and safety monitoring board are listed in reference 14 of this article.

Spinal cord-injured (SCI) patients are at increased risk for fractures secondary to neurogenic osteoporosis. Earlier research claimed physical conditioning resulted in a decreased incidence or reversal of neurogenic osteoporosis. This study evaluated the effects of functional electrical stimulation-induced lower extremity cycling (FESILEC) on the bone densities of SCI patients using dual-energy x/ray absorptiometry (DEXA). The study consisted of 12 healthy male SCI patients, aged 23 to 46 (x +/- SD, 34 +/- 6) yr. The patients were post-traumatic, complete, spastic SCI; time postinjury ranged from 2 to 19 (9.7 +/- 5.1) yr. Patients participated in a three-phase training program. Phase 1 consisted of quadriceps strengthening. Phase 2 consisted of progressive sequential stimulation of quadriceps, hamstrings, and gluteal muscles, achieving a rhythmical pedaling motion on the REGYS I ergometer. Phase 3a consisted of 30-min FESILEC sessions. DEXAs were done at baseline and at completion of Phase 3a and Phase 3b. Bone densities were done of the lumbar spine levels 2-4 (L2-4), bilateral trochanters (T), Ward's triangles (WT) and femoral necks (FN). Baseline bone density indicated no difference between L2-4 of ambulatory males and SCI males. Baseline values obtained for T, WT, and FN were, respectively, 71, 82, and 79% of ambulatory values. Results after completion of the Phase 3a training program indicated no statistically significant difference compared with baseline values. There was, however, a positive trend in the lumbar spine post-Phase 3a (L2-4, P=0.056). Eight patients continued the exercise program, using a combination of upper and lower extremity cycling (Phase 3b) for a longer period of time (25 +/- 9 wk). DEXAs done after Phase 3b indicated no change relative to baseline data or data post-Phase 3a. In conclusion, although FESILEC did not significantly increase bone density in the hip parameters of chronic SCI patients, a positive trend was observed in the lumbar spine. Further research with acute intervention, such as FESILEC during the first few months post-SCI, is warranted to further evaluate a treatment regimen to prevent or reduce neurogenic osteopenia.

No abstract

No abstract

ClinicalTrials.gov Identifier: NCT00344500.