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Journal of the Korean Academy of Rehabilitation Medicine 1994;18(1):16.
A Study on the Effects of Weight Bearing Exercises on the Bone Density in Spinal Cord Injury Patients
Bang-Hoon Lee, M.D., Min-Ho Kim, M.D.* , Kang-Mok Lee M.D.*
Lee Bang-Hoon's Rehabilitation Medicine Clinic, Department of Rehabilitation Medicine, College of Medicine, Hanyang University*
척수손상자의 대퇴 골밀도에 대한 체중부하운동 효과에 관한 연구
이방훈, 김민호*, 이강목*
이방훈 재활의학과의원, 한양대학교 의과대학 재활의학교실*

It is a well known fact that osteoporosis is an inevitable complication in patients with spinal cord injuries. This study focused on the degree of bone density of the femur in complete paraplegics and quadriplegics after their injuries and effect of the weight bearing exercises 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 fo 21 complete paraplegics had walking exercies 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.

The results of the study were as follows.

1) The bone density of the femoral neck, Ward triangle and femoral trochanter in the control group were 0.98 g/cm2, 0.88 g/cm2 and 0.84 g/cm2 respectively, and 0.82 g/cm2, 0.72 g/cm2, 0.66 g/cm2 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 to 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 0.86 g/cm2, 95.3%. 0.76 g/cm2, 90.7% and 0.72 g/cm2, 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 0.82 g/cm2, 91.4%, 0.73 g/cm2, 86.6%, and 0.65 g/cm2, 88.1% respectively. There was no significant difference between the average femoral bone density 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.

Key Words: Bone densitometry, Osteoporosis, Spinal cord injury, Exercise


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