Department of Kinesiology, California State University, San Marcos, 333. S. Twin Oaks Valley Road, UNIV 320, San Marcos, CA, 92096-0001, USA,
Eur J Appl Physiol. 2013 Dec;113(12):3027-37. doi: 10.1007/s00421-013-2738-0. Epub 2013 Oct 6.
Osteoporosis is a severe complication of spinal cord injury (SCI). Many exercise modalities are used to slow bone loss, yet their efficacy is equivocal. This study examined the effect of activity-based therapy (ABT) targeting the lower extremities on bone health in individuals with SCI.
Thirteen men and women with SCI (age and injury duration = 29.7 ± 7.8 and 1.9 ± 2.7 years) underwent 6 months of ABT. At baseline and after 3 and 6 months of training, blood samples were obtained to assess bone formation (serum procollagen type 1 N propeptide (PINP) and bone resorption (serum C-terminal telopeptide of type I collagen (CTX), and participants underwent dual-energy X-ray absorptiometry scans to obtain total body and regional estimates of bone mineral density (BMD).
Results demonstrated significant increases (p < 0.05) in spine BMD (+4.8 %; 1.27 ± 0.22-1.33 ± 0.24 g/cm(2)) and decreases (p < 0.01) in total hip BMD (-6.1 %; 0.98 ± 0.18-0.91 ± 0.16 g/cm(2)) from 0 to 6 months of training. BMD at the bilateral distal femur (-7.5 to -11.0 %) and proximal tibia (- 8.0 to -11.2 %) declined but was not different (p > 0.05) versus baseline. Neither PINP nor CTX was altered (p > 0.05) with training.
Chronic activity-based therapy did not reverse bone loss typically observed soon after injury, yet reductions in BMD were less than the expected magnitude of decline in lower extremity BMD in persons with recent SCI.
骨质疏松症是脊髓损伤（SCI）的严重并发症。许多运动方式被用于减缓骨质流失，但它们的疗效存在争议。本研究旨在探讨针对下肢的基于活动的治疗（ABT）对 SCI 患者骨骼健康的影响。
13 名 SCI 男性和女性（年龄和损伤持续时间分别为 29.7±7.8 岁和 1.9±2.7 年）接受了 6 个月的 ABT。在基线和训练 3 个月和 6 个月后，采集血液样本以评估骨形成（血清型前胶原 1 N 端肽（PINP）和骨吸收（血清 I 型胶原 C 端肽（CTX），并对参与者进行双能 X 射线吸收法扫描，以获得全身和区域骨密度（BMD）估计值。
结果显示，训练 0 至 6 个月后，脊柱 BMD 显著增加（p<0.05；+4.8%；1.27±0.22-1.33±0.24 g/cm²），总髋部 BMD 显著降低（p<0.01；-6.1%；0.98±0.18-0.91±0.16 g/cm²）。双侧股骨远端（-7.5 至-11.0%）和胫骨近端（-8.0 至-11.2%）的 BMD 下降，但与基线相比无差异（p>0.05）。PINP 和 CTX 均未随训练而改变（p>0.05）。
慢性基于活动的治疗并未逆转损伤后早期通常观察到的骨质流失，但 BMD 的减少低于近期 SCI 患者下肢 BMD 预期的下降幅度。
