Giangregorio L M, Hicks A L, Webber C E, Phillips S M, Craven B C, Bugaresti J M, McCartney N
Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute, Ontario, Canada.
Spinal Cord. 2005 Nov;43(11):649-57. doi: 10.1038/sj.sc.3101774.
Longitudinal prospective case series.
To evaluate the impact of early introduction post-spinal cord injury (SCI) of twice-weekly body-weight supported treadmill training (BWSTT) on muscle and bone.
Centre for Health Promotion and Rehabilitation, McMaster University, Canada.
Five individuals who had sustained traumatic SCI within 2-6 months participated in the study. Bone mineral densities (BMD) of proximal femur, distal femur, proximal tibia and lumbar spine were measured before and after training, as well as muscle cross-sectional area (CSA), BMD and bone geometry at mid-femur and proximal tibia. Serum osteocalcin and urinary deoxypyridinoline were measured at baseline, and after 24 and 48 sessions of training.
All participants experienced increased muscle CSAs, ranging from 3.8 to 56.9%. Reductions in BMD were evident in all participants at almost all lower limb sites after training, ranging in magnitude from -1.2 to -26.7%. Lumbar spine BMD changes ranged from 0.2 to -7.4%. No consistent changes were observed in bone geometry. BWSTT did not alter the expected pattern of change in bone biochemical markers over time. The individual with the greatest improvement in ambulatory ability demonstrated the smallest reduction in lower limb BMD. Conversely, the individual who completed the fewest BWSTT sessions demonstrated the greatest reductions in BMD.
Twice-weekly BWSTT appeared to partially reverse muscle atrophy after SCI, but did not prevent bone loss. Larger, controlled trials should evaluate whether relative preservation of bone loss occurs with regular BWSTT following acute SCI.
Ontario Neurotrauma Foundation.
纵向前瞻性病例系列研究。
评估脊髓损伤（SCI）后早期开始每周两次的体重支持式跑步机训练（BWSTT）对肌肉和骨骼的影响。
加拿大麦克马斯特大学健康促进与康复中心。
5名在2至6个月内遭受创伤性SCI的个体参与了本研究。在训练前后测量股骨近端、股骨远端、胫骨近端和腰椎的骨密度（BMD），以及股骨中段和胫骨近端的肌肉横截面积（CSA）、BMD和骨几何形态。在基线时以及训练24次和48次后测量血清骨钙素和尿脱氧吡啶啉。
所有参与者的肌肉CSA均增加，增幅在3.8%至56.9%之间。训练后，几乎所有下肢部位的所有参与者的BMD均明显降低，降幅在-1.2%至-26.7%之间。腰椎BMD变化范围为0.2%至-7.4%。未观察到骨几何形态的一致变化。BWSTT并未改变骨生化标志物随时间变化的预期模式。步行能力改善最大的个体下肢BMD降低最小。相反，完成BWSTT训练次数最少的个体BMD降低最大。
每周两次的BWSTT似乎部分逆转了SCI后的肌肉萎缩，但未能预防骨质流失。规模更大的对照试验应评估急性SCI后定期进行BWSTT是否能相对减少骨质流失。
安大略省神经创伤基金会。
