Effect of prolonged bed rest on bone mineral

Donaldson, Charles L.; Hulley, Stephen B.; Vogel, John M.; Hattner, Robert S.; Bayers, Jon H.; McMillan, D. E.

doi:10.1016/0026-0495(70)90032-6

Cited by 467 publications

(181 citation statements)

References 22 publications

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“…Physical inactivity or prolonged bed rest results in loss of bone mass. 5,28 The recovery from immobilization bone loss has also been observed. 6 The time from the diagnosis of hematologic disease to recovery after BMT is several months and most patients spend more time at the hospital than at home during this period.…”

Section: Discussionmentioning

confidence: 68%

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Bone mineral density after allogeneic bone marrow transplantation

Kauppila

Irjala²,

Koskinen³

et al. 1999

Bone Marrow Transplant

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Summary:Bone turnover markers and bone mineral density (BMD) were studied in 25 adult patients (14 females, 11 males) who had undergone allogeneic bone marrow transplantation (BMT). The interval from BMT to the first examination was at least 1 year (mean 3, range 1-10). Mean age of the patients at the time of first evaluation was 42 (range 19-54) years. Blood samples and urine collections for evaluation of biochemical factors reflecting skeletal turnover were performed together with the first BMD measurement. BMD was measured from the lumbar vertebrae (L2 to L4) with computed tomography and results were expressed as Z-scores. At the time of the first measurement five patients (20%) had Z-scores Ͻ−2.5 s.d. and 12 patients (48%) between −1 and −2.5 s.d. In 12 patients BMD assessments were repeated and it seemed that reduction in BMD had mostly occurred during and shortly after BMT and remained the same during follow-up. The cross-linked carboxyterminal telopeptide of type I collagen (ICTP) correlated negatively with BMD (r = −0.45, P = 0.045) as did bone-specific alkaline phosphatase (BAP; r = −0.64, P = 0.002). No correlation between BMD and time interval from diagnosis to BMT, conditioning regimen, corticosteroid use or hospital stay during transplantation was found. In conclusion, bone disease is common after BMT. Our findings demonstrate an increased collagen and bone turnover and a high risk of osteoporosis. BMD measurements must be repeated regularly and collagen markers such as ICTP and BAP can be beneficial in estimating the activity of bone disease. Keywords: allogeneic bone marrow transplantation; ICTP; bone-specific alkaline phosphatase; bone mineral density; osteoporosis Transplant recipients are at risk of osteoporosis. Muchmore et al 1 reported low mean density of vertebral bone in heart transplant patients. Bone loss takes place mostly during the initial year after transplantation. 2 Rapid loss of vertebral mineral density has also been reported after renal transplantation, with most of the loss occurring within the first 6 months. after. Bone loss was related to number of hospital days but not to any other factor.Patients after allogeneic BMT are also exposed to numerous factors that can affect bone mineral metabolism: induction and consolidation therapies, bed rest, 5,6 conditioning regimen for BMT, steroids, 7 CsA therapy 8,9 and GVHD. 10 In female patients disturbance of gonadal function causes chronic estrogen deficiency 11 with an increased risk for osteoporosis. Carlson et al 12 studied the effect of myeloablative therapy on bone metabolism during the first 3 months after transplantation and found significant changes in serum markers of bone metabolism, which implied a net loss of bone over the study period. In 1997 Keilholz et al 13 reported normal BMDs after ABMT with a median interval of 5 years from autografting.The purpose of the present study was to evaluate the occurrence of bone disease after BMT by measuring BMD and biochemical markers of bone metabolism. Patients and methodsWe exami...

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Section: Discussionmentioning

confidence: 68%

“…Patients after allogeneic BMT are also exposed to numerous factors that can affect bone mineral metabolism: induction and consolidation therapies, bed rest, 5,6 conditioning regimen for BMT, steroids, 7 CsA therapy 8,9 and GVHD. 10 In female patients disturbance of gonadal function causes chronic estrogen deficiency 11 with an increased risk for osteoporosis.…”

mentioning

confidence: 99%

Bone mineral density after allogeneic bone marrow transplantation

Kauppila

Irjala²,

Koskinen³

et al. 1999

Bone Marrow Transplant

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“…Bed rest is a well-accepted analog for many of the physiological effects of space flight, especially musculoskeletal changes [5,12,13,27,34,47,51].…”

Section: Introductionmentioning

confidence: 99%

Lower body negative pressure treadmill exercise as a countermeasure for bed rest-induced bone loss in female identical twins

Zwart

Hargens

Lee

et al. 2007

Bone

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Supine weight-bearing exercise within lower body negative pressure (LBNP) alleviates some of the skeletal deconditioning induced by simulated weightlessness in men. We examined the potential beneficial effect in women. Because dietary acid load affected the degree of bone resorption in men during bed rest, we also investigated this variable in women. Subjects were 7 pairs of female identical twins assigned at random to 2 groups, sedentary bed rest (control) or bed rest with supine treadmill exercise within LBNP. Dietary intake was controlled and monitored. Urinary calcium and markers of bone resorption were measured before bed rest (BR) and on BR days 5/6, 12/13, 19/20, and 26/27. Bone mineral content was assessed by dual-energy X-ray absorptiometry before and after bed rest. Data were analyzed by repeated measures two-way analysis of variance. Pearson correlation coefficients were used to define the relationships between diet and markers of bone metabolism, and to estimate heritability of markers. During bed rest, all markers of bone resorption and urinary calcium and phosphorus increased (P < 0.001); parathyroid hormone (P = 0.06), bone-specific alkaline phosphatase (P = 0.06), and 1,25-dihydroxyvitamin D (P = 0.09) tended to decrease. LBNP exercise tended to mitigate bone density loss. The ratio of dietary animal protein to potassium was positively correlated with urinary calcium excretion for all weeks of bed rest in the control group, but only during weeks 1 and 3 for the exercise group. Pre-bed rest data suggested that many markers of bone metabolism have strong genetic determinants. Treadmill exercise within LBNP had less of a protective effect on bone resorption during bed rest in women than previously-published results had Sources of support: This study was funded by NASA through grant NAG 9-1425 and by NIH through grant GCRC M01-RR00827 to UCSD.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. shown for its effect in men, but the same trends were observed for both sexes. Dietary acid load of these female subjects was significantly correlated with calcium excretion but not with other bone resorption markers. NIH Public Access

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“…The loss of calcium from the bones has of course been measured in patients after periods of resting in bed (Donaldson et al, 1970) and it has been postulated that muscle activity is associated with the normal mechanisms of maintaining bone mass (Bassett and Becker, 1962). However, this study shows that persistent paralysis does not lead to a continuing fall in bone mass and some other factor or factors are presumably involved in maintaining a constant but reduced bone mass.…”

Section: Discussionmentioning

confidence: 75%

Bone and soft tissue changes in paraplegic patients

1979

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Abstract. Th e loss of bone mineral in 66 paraplegic patients has been measured in th e lower femoral shaft by scanning the leg with a beam of mono-energetic radiation from 2 4 1 A m. The profile of the transmitted radiation was used to determine a parameter wh ich was related to bone mass. The bone mass of paraplegic patients was significantly lower than normal. Persistent paralysis does not lead to a continued fall in bone mass, but once it has fallen, bone mass remains constant. Soft tissues also sh owed a muscle/ fat ratio that was lower than normal.

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Effect of prolonged bed rest on bone mineral

Cited by 467 publications

References 22 publications

Bone mineral density after allogeneic bone marrow transplantation

Bone mineral density after allogeneic bone marrow transplantation

Lower body negative pressure treadmill exercise as a countermeasure for bed rest-induced bone loss in female identical twins

Bone and soft tissue changes in paraplegic patients

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