AA

Combination Interventions

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As this chapter goes to press, the first generation of studies of combination interventions for treatment of bone loss in chronic SCI are being completed. These studies evaluate the concurrent administration of pharmacological therapy with non-pharmacological rehabilitation interventions. Some examples of registered trials include studies of zoledronate in combination with FES rowing, and recombinant parathyroid hormone (rPTH, Forteo) in combination with weight bearing. Table 13 describes the early results from one such trial.

Table 13: Studies of Combination Interventions for Treatment of Bone

Discussion

One study of concurrent teriparatide and body-weight supported treadmill stepping did not provide evidence in support of this combination intervention for treatment of bone loss in SCI. However, this study used a convenience sample with a small N, and was not powered to detect significant intervention effects.

Conclusion

There is no evidence to support concurrent treatment of low bone mass with teriparatide and body-weight supported treadmill training.