It is a well known fact that osteoporosis is an inevitable complicationin patients with spinal cord injuries. This study foucused on the degree of bone density of the femur in complete paraplegics and quadriplegics after their injuries and effect
of the
weight bearing exercise on bone density in spinal cord injury (SCI) patients.
The subjects were 29 complete SCI patients (8 quadriplegics, 21 paraplegics) and 29 healthy volunteers as the control.
Using the DP4-dual photon absorptiometry (44 keV, 100 keV) from Lunar, the bone mineral density (BMD) of the right femoral neck, Ward triangle and the femoral trochanter were measured. 13 of 21 complete paraplegics had walking exercise with leg
braces
on for at least 45 minutes a day, 6 times a week and 5.5 months average. 3 of 8 complete quadriplegics were put on the tilt table for 30 minutes each twice daily and 4 months average. The BMD was measured before the weight bearing exercises and
compared
to those afterwards. To compare the changes in bone density in relation to the time after the injury and the changes after the weight bearing exercises, the age-matched percent of BMD of the patients was obtained from the normal femoral BMD.
@ES The results of the study were as follows.
@EN 1) the bone density of the femoral neck, Ward triangle and femoral trochanter in the control group were 0.98g/㎠, 0.88g/㎠ and 0.84g/㎠ respectively, and 0.82g/㎠, 0.72g/㎠, 0.66g/㎠ in the patients. comparing with the control group, the
patient
group significantly decreased (p<0.001). The age-matched percent of BMD of the femoral neck, Ward triangle and femoral trochanter in the patients were 91.1%, 87.3% and 89.4%.
2) The period after the spinal cord injury was an average 9.6 months. The change in bone density in relation toe the period after the spinal cord injury was found to be inconsistent in the femoral neck and Ward triangle (p>0.05), but showed a
decrease
of 1.3% a month in the femoral trochanter (r=-0.367, p=0.05).
3) The average bone density and age-matched percent of BMD of the femoral neck Ward triangle and femoral trochanter in paraplegics before starting the weight bearing exercises were 0.86g/㎠, 95.3%, 0.76g/㎠, 90.7% and 0.72g/㎠, 97.5%. even after
weight
bearing exercises for an average of 5.5 months, the bone density and percent in paraplegics decreased significantly (p<0.05) as 0.82g/㎠, 91.4%, 0.73g/㎠, 86.8%, and 0.65g/㎠, 88.1% respectively. There was no significant differece between the
average
femoral bone donsity and average femoral percent of BMD in quadraplegics before and after the exercises (p>0.05).
These results indicate that osteoporosis related to spinal cord injuries may not be prevented or treated by weight bearing exercises alone.
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