Standing

Discussion

There is inconclusive evidence for Reciprocating Gait Orthosis, long leg braces or passive standing as a treatment for low bone mass after SCI. One mixed cross-sectional and a longitudinal study found that participants who underwent quadriceps activation during stance with 150% body weight compressive load, had significantly higher BMD than participants who underwent quadriceps activation during stance with 40% body weight compressive load and passive standing. One cross-sectional study (Goemaere et al. 1994) used a self-report physical activity measure to highlight the potential for standing to reduce BMD decline at the femoral shaft; patients with long leg braces had a significantly higher trochanter and total BMD compared with standing frame or standing wheelchair. In contrast, another cross-sectional investigation of bone outcomes and self-report physical activity measures found no effect of activity on lower extremity bone parameters (Jones et al. 2002).

Conclusions

There is inconclusive evidence for Reciprocating Gait Orthosis, long leg braces, passive standing, or self-reported physical activity as a treatment for low bone mass.

There is level 4 evidence (Dudley-Javoroski et al. 2012) for quadriceps activation during stance with 150% body weight compressive load to increase BMD.