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本文引用的文献

1
International standards for neurological classification of spinal cord injury (revised 2011).脊髓损伤神经学分类国际标准（2011年修订）
J Spinal Cord Med. 2011 Nov;34(6):535-46. doi: 10.1179/204577211X13207446293695.
2
High dose compressive loads attenuate bone mineral loss in humans with spinal cord injury.高剂量压缩负荷可减少脊髓损伤患者的骨矿物质丢失。
Osteoporos Int. 2012 Sep;23(9):2335-46. doi: 10.1007/s00198-011-1879-4. Epub 2011 Dec 21.
3
Effects of obesity on bone metabolism.肥胖对骨代谢的影响。
J Orthop Surg Res. 2011 Jun 15;6:30. doi: 10.1186/1749-799X-6-30.
4
Enhancing muscle force and femur compressive loads via feedback-controlled stimulation of paralyzed quadriceps in humans.通过反馈控制刺激人类瘫痪的股四头肌增强肌肉力量和股骨压缩负荷。
Arch Phys Med Rehabil. 2011 Feb;92(2):242-9. doi: 10.1016/j.apmr.2010.10.031.
5
Altered mRNA expression after long-term soleus electrical stimulation training in humans with paralysis.瘫痪患者进行长期比目鱼肌电刺激训练后的 mRNA 表达改变。
Muscle Nerve. 2011 Jan;43(1):65-75. doi: 10.1002/mus.21831.
6
A role for myokines in muscle-bone interactions.肌因子在肌肉骨骼相互作用中的作用。
Exerc Sport Sci Rev. 2011 Jan;39(1):43-7. doi: 10.1097/JES.0b013e318201f601.
7
Reliability and responsiveness of musculoskeletal ultrasound in subjects with and without spinal cord injury.肌肉骨骼超声在伴有和不伴有脊髓损伤的受试者中的可靠性和反应性。
Ultrasound Med Biol. 2010 Oct;36(10):1594-607. doi: 10.1016/j.ultrasmedbio.2010.07.019.
8
Myostatin (GDF-8) as a key factor linking muscle mass and bone structure.肌生成抑制素（生长分化因子8）作为连接肌肉质量与骨骼结构的关键因子。
J Musculoskelet Neuronal Interact. 2010 Mar;10(1):56-63.
9
Longitudinal changes in femur bone mineral density after spinal cord injury: effects of slice placement and peel method.脊髓损伤后股骨骨密度的纵向变化：切片位置和去皮方法的影响。
Osteoporos Int. 2010 Jun;21(6):985-95. doi: 10.1007/s00198-009-1044-5. Epub 2009 Aug 26.
10
Asymmetric bone adaptations to soleus mechanical loading after spinal cord injury.脊髓损伤后比目鱼肌机械负荷的不对称骨适应
J Musculoskelet Neuronal Interact. 2008 Jul-Sep;8(3):227-38.

主动抗阻站立姿势可调节脊髓损伤患者的局部骨矿物质密度。

Active-resisted stance modulates regional bone mineral density in humans with spinal cord injury.

作者信息

Dudley-Javoroski Shauna, Shields Richard K

机构信息

Department of Physical Therapy & Rdhabilitation Science, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.

出版信息

J Spinal Cord Med. 2013 May;36(3):191-9. doi: 10.1179/2045772313Y.0000000092.

DOI:10.1179/2045772313Y.0000000092
PMID:23809588
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3654444/
Abstract

OBJECTIVE

In people with spinal cord injury (SCI), active-resisted stance using electrical stimulation of the quadriceps delivered a therapeutic stress to the femur (∼150% of body weight) and attenuated bone mineral density (BMD) decline. In standard densitometry protocols, BMD is averaged over the entire bone cross-section. An asymmetric adaptation to mechanical load may be masked by non-responding regions. The purpose of this study was to test a novel method to assess regional BMD of the femur in individuals with SCI. We hypothesize that there will be regional bone-sparing changes as a result of active-resisted stance.

DESIGN

Mixed cross-sectional and longitudinal.

SETTING

Research laboratory.

PARTICIPANTS

Twelve individuals with SCI and twelve non-SCI controls.

INTERVENTION

Individuals with SCI experienced active-resisted stance or passive stance for up to 3 years.

OUTCOME MEASURES

Peripheral quantitative computed tomography images from were partitioned so that femur anatomic quadrants could be separately analyzed.

RESULTS

Over 1.5 years, the slope of BMD decline over time was slower at all quadrants for the active-resisted stance limbs. At >2 years of training, BMD was significantly higher for the active-resisted stance group than for the passive stance group (P = 0.007). BMD was preferentially spared in the posterior quadrants of the femur with active-resisted stance.

CONCLUSIONS

A regional measurement technique revealed asymmetric femur BMD changes between passive stance and active-resisted stance. Future studies are now underway to better understand other regional changes in BMD after SCI.

摘要

目的

在脊髓损伤（SCI）患者中，通过电刺激股四头肌进行主动抗阻站立会给股骨带来治疗性压力（约为体重的150%），并减缓骨密度（BMD）下降。在标准骨密度测量方案中，BMD是在整个骨横截面上进行平均计算的。对机械负荷的不对称适应性变化可能会被无反应区域掩盖。本研究的目的是测试一种评估SCI患者股骨局部BMD的新方法。我们假设主动抗阻站立会导致局部骨保留变化。

设计

混合横断面和纵向研究。

地点

研究实验室。

参与者

12名SCI患者和12名非SCI对照者。

干预

SCI患者进行长达3年的主动抗阻站立或被动站立。

结果测量

对来自外周定量计算机断层扫描图像进行分区，以便能够分别分析股骨的解剖象限。

结果

在1.5年的时间里，主动抗阻站立肢体所有象限的BMD随时间下降的斜率较慢。在训练超过2年后，主动抗阻站立组的BMD显著高于被动站立组（P = 0.007）。主动抗阻站立时，股骨后象限的BMD优先得到保留。

结论

一种局部测量技术揭示了被动站立和主动抗阻站立之间股骨BMD的不对称变化。目前正在进行进一步研究，以更好地了解SCI后BMD的其他局部变化。