Coupaud S, Jack L P, Hunt K J, Allan D B
Centre for Rehabilitation Engineering, Department of Mechanical Engineering, University of Glasgow, Glasgow, UK.
J Musculoskelet Neuronal Interact. 2009 Oct-Dec;9(4):288-97.
We describe the use of peripheral Quantitative Computed Tomography (pQCT) to identify musculoskeletal responses to partial body-weight supported treadmill training (BWSTT) in incomplete spinal cord injury (SCI). Long-term health consequences of SCI include extensive muscle atrophy, severe bone loss and an increased fracture risk in the affected limbs, mostly at both tibial epiphyses and the distal femoral epiphysis. Regular treadmill training may slow or reverse bone loss by recruiting available lower-limb musculature and loading the leg bones dynamically. The potential for detailed analysis of musculoskeletal changes using pQCT is illustrated with a single case study (14.5 years post-SCI), who completed seven months of partial BWSTT. Pre- and post-training lower-limb pQCT scans were taken to quantify changes in trabecular bone, cortical bone, and soft-tissue. Trabecular bone mineral density increased by 5% (right) and 20% (left) in the distal tibia. Changes in proximal tibia and distal femur were negligible. Increases in muscle cross-sectional area were 6% (right) and 12% (left) in the lower leg, 7% (right) and 5% (left) in the thigh. We suggest that treadmill training may lead to positive musculoskeletal adaptations at clinically-relevant sites. Such changes can be measured in detail using pQCT.
我们描述了使用外周定量计算机断层扫描（pQCT）来识别不完全性脊髓损伤（SCI）患者对部分体重支持的跑步机训练（BWSTT）的肌肉骨骼反应。SCI的长期健康后果包括广泛的肌肉萎缩、严重的骨质流失以及受影响肢体骨折风险增加，主要发生在胫骨两端和股骨远端骨骺。定期的跑步机训练可以通过调动可用的下肢肌肉组织并动态加载腿部骨骼来减缓或逆转骨质流失。通过一个单病例研究（SCI后14.5年）展示了使用pQCT详细分析肌肉骨骼变化的潜力，该患者完成了七个月的部分BWSTT。训练前后进行下肢pQCT扫描以量化小梁骨、皮质骨和软组织的变化。胫骨远端的小梁骨矿物质密度右侧增加了5%，左侧增加了20%。胫骨近端和股骨远端的变化可忽略不计。小腿肌肉横截面积右侧增加了6%，左侧增加了12%；大腿肌肉横截面积右侧增加了7%，左侧增加了5%。我们认为跑步机训练可能会在临床相关部位导致积极的肌肉骨骼适应性变化。使用pQCT可以详细测量这些变化。
