Giangregorio Lora, McCartney Neil
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
J Spinal Cord Med. 2006;29(5):489-500. doi: 10.1080/10790268.2006.11753898.
Individuals with spinal cord injury (SCI) often experience bone loss and muscle atrophy. Muscle atrophy can result in reduced metabolic rate and increase the risk of metabolic disorders. Sublesional osteoporosis predisposes individuals with SCI to an increased risk of low-trauma fracture. Fractures in people with SCI have been reported during transfers from bed to chair, and while being turned in bed. The bone loss and muscle atrophy that occur after SCI are substantial and may be influenced by factors such as completeness of injury or time postinjury. A number of interventions, including standing, electrically stimulated cycling or resistance training, and walking exercises have been explored with the aim of reducing bone loss and/or increasing bone mass and muscle mass in individuals with SCI. Exercise with electrical stimulation appears to increase muscle mass and/or prevent atrophy, but studies investigating its effect on bone are conflicting. Several methodological limitations in exercise studies with individuals with SCI to date limit our ability to confirm the utility of exercise for improving skeletal status. The impact of standing or walking exercises on muscle and bone has not been well established. Future research should carefully consider the study design, skeletal measurement sites, and the measurement techniques used in order to facilitate sound conclusions.
脊髓损伤（SCI）患者常出现骨质流失和肌肉萎缩。肌肉萎缩会导致代谢率降低，并增加代谢紊乱的风险。亚损伤性骨质疏松症使SCI患者发生低创伤骨折的风险增加。据报道，SCI患者在从床上转移到椅子上以及在床上翻身时会发生骨折。SCI后发生的骨质流失和肌肉萎缩很严重，可能受损伤完整性或受伤后时间等因素影响。为了减少SCI患者的骨质流失和/或增加骨量和肌肉量，人们探索了多种干预措施，包括站立、电刺激循环或阻力训练以及步行锻炼。电刺激运动似乎能增加肌肉量和/或防止萎缩，但研究其对骨骼影响的结果相互矛盾。迄今为止，针对SCI患者的运动研究存在若干方法学局限性，限制了我们确认运动对改善骨骼状况效用的能力。站立或步行锻炼对肌肉和骨骼的影响尚未明确。未来的研究应仔细考虑研究设计、骨骼测量部位以及所使用的测量技术，以便得出可靠的结论。
