Exploring the determinants of fracture risk among individuals with spinal cord injury

Lala, Deena; Craven, B. Catharine; Thabane, Lehana; Παπαϊωάννου, Αλεξάνδρα; Adachi, Jonathan D.; Popović, Miloš R.; Giangregorio, Lora

doi:10.1007/s00198-013-2419-1

Cited by 69 publications

(35 citation statements)

References 43 publications

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“…41 The prospective, observational cohort study was designed to examine a number of primary and secondary research questions related to musculoskeletal health in individuals with chronic SCI. Seventy participants (50 men and 20 women) with SCI (C2-T12, American Spinal Injury Association Impairment Scale [AIS] A-D) were included.…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

“…Our protocol for pQCT acquisition and analysis has been described in a previous publication. 41 Single 2.5-mm slices were completed at distal tibia (4% tibia length) and proximal one-third tibia (66% tibia length). A voxel size of 0.2 mm was used at the 4% site and 0.5 mm was used at the 66% site.…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

“…Supine height (cm), body mass (kg), and waist circumference (cm) were measured according to SCI-specific anthropometric measurement protocols previously published. 41,42 The proportion of participants who met the body mass index (BMI) (≥22 kg/m 2 ) and waist circumference (≥94 cm) criteria for SCIspecific definitions of obesity were determined. 43,44 Mobility status was dichotomously classified as using or not using a wheelchair for community mobility.…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

“…Recruitment strategies were described in a previous publication. 41 Written informed consent was obtained from all participants prior to the conduct of formal assessments to determine study eligibility. The current study was approved by the University Health Network and University of Waterloo research ethics boards.…”

Section: Participantsmentioning

confidence: 99%

“…Secondary analyses using baseline data from this cohort study have been previously published. 3,13,41,51 Independent samples t tests were performed to compare bone quality and muscle outcomes in participants with chronic SCI grouped by sex (men vs women) and AIS classification (AIS A/B vs AIS C/D). Pearson's correlations were performed to determine the strength of the associations between muscle density and indices of bone quality.…”

Section: Statistical Analysesmentioning

confidence: 99%

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Muscle Density and Bone Quality of the Distal Lower Extremity Among Individuals with Chronic Spinal Cord Injury

Gibbs

Craven

Moore

et al. 2015

Topics in Spinal Cord Injury Rehabilitation

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Background:Understanding the related fates of muscle density and bone quality after chronic spinal cord injury (SCI) is an important initial step in determining endocrine-metabolic risk. Objective: To examine the associations between muscle density and indices of bone quality at the distal lower extremity of adults with chronic SCI. Methods: A secondary data analysis was conducted in 70 adults with chronic SCI (C2-T12; American Spinal Injury Association Impairment Scale .9]) (P < .05), whereas cLEMS was most strongly associated with TbBMD (b = 7.69 [4.63, 10.76]) (P < .001). Conclusion: Muscle density and function were most strongly associated with TbBMD at the distal tibia in adults with chronic SCI, whereas muscle size was most strongly associated with bone size and geometry at the tibial shaft. Key words: bone mineral density, bone quality, muscle density, muscle size, osteoporosis, peripheral quantitative computed tomography, spinal cord injury S pinal cord injury (SCI) is associated with sublesional muscle atrophy, 1-3 changes in muscle fiber type, 4,5 reductions in hip and knee region bone mineral density (BMD), [6][7][8] and increased central and regional adiposity after injury.9,10 Adverse changes in muscle and bone health in individuals with SCI contribute to an increased risk of osteoporosis, 11-13 fragility fractures, 14 and endocrine-metabolic disease (eg, diabetes, dyslipidemia, heart disease).15-17 Crosssectional studies have shown a higher prevalence of lower extremity fragility fractures among individuals with SCI ranging from 1% to 34%. [18][19][20] Fragility fractures are associated with negative health and functional outcomes, including an increased risk of morbidity and hospitalization, 21,22 mobility limitations, 23 and a reduced quality of life.

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Section: Study Design and Data Collectionmentioning

confidence: 99%

Section: Study Design and Data Collectionmentioning

confidence: 99%

Section: Study Design and Data Collectionmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

See 3 more Smart Citations

Muscle Density and Bone Quality of the Distal Lower Extremity Among Individuals with Chronic Spinal Cord Injury

Gibbs

Craven

Moore

et al. 2015

Topics in Spinal Cord Injury Rehabilitation

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Spinal Cord Injury Associated Disease of the Skeleton, an Unresolved Problem with Need for Multimodal Interventions

Echevarria‐Cruz,

McMillan,

Reid

et al. 2024

Advanced Biology

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Spinal cord injury is associated with skeletal unloading, sedentary behavior, decreases in skeletal muscle mass, and exercise intolerance, which results in rapid and severe bone loss. To date, monotherapy with physical interventions such as weight‐bearing in standing frames, computer‐controlled electrically stimulated cycling and ambulation exercise, and low‐intensity vibration are unsuccessful in maintaining bone density after SCI. Strategies to maintain bone density with commonly used osteoporosis medications also fail to provide a significant clinical benefit, potentially due to a unique pathology of bone deterioration in SCI. In this review, the available data is discussed on evaluating and monitoring bone loss, fracture, and physical and pharmacological therapeutic approaches to SCI‐associated disease of the skeleton. The treatment of SCI‐associated disease of the skeleton, the implications for clinical management, and areas of need are considered for future investigation.

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The Physiology of Exercise in Spinal Cord Injury (SCI): An Overview of the Limitations and Adaptations

Mercier

Taylor

2016

The Physiology of Exercise in Spinal Cord Injury

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Exploring the determinants of fracture risk among individuals with spinal cord injury

Abstract: Low knee aBMD and suboptimal bone geometry are significantly associated with fractures. Prospective studies are necessary to confirm the bone parameters reported to predict fracture risk in individuals with low bone mass and chronic SCI.

Cited by 69 publications

References 43 publications

Muscle Density and Bone Quality of the Distal Lower Extremity Among Individuals with Chronic Spinal Cord Injury

Muscle Density and Bone Quality of the Distal Lower Extremity Among Individuals with Chronic Spinal Cord Injury

Spinal Cord Injury Associated Disease of the Skeleton, an Unresolved Problem with Need for Multimodal Interventions

The Physiology of Exercise in Spinal Cord Injury (SCI): An Overview of the Limitations and Adaptations

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