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Discussion

There is no evidence to support physical activity as a treatment for low bone mass after SCI. One cross-sectional study (Chain et al. 2012) used a self-report physical activity measure to highlight the differences in BMD between self-reported “active” and “sedentary” patients; active patients did not differ from sedentary patients in any bone parameter, and the sedentary group had significantly higher lumbar spine BMD.

Conclusion

There is no evidence to support physical activity as a treatment for low bone mass after SCI.

Table 16: Physical Activity for Bone Health after SCI

Author Year; Country
Score
Research Design
Total Sample Size
MethodsOutcome
Chain et al. 2012

Brazil

Cross-sectional

Level 5

N=25

Population: 25 men with traumatic quadriplegia. 2 groups: Active (n=10; age: 30 ±9 years; TPI: 8 ± 7 years) and Sedentary (n=15; age: 36 ± 11 years; TPI: 15 ± 9 years.

Treatment: No treatment – comparison of active vs. sedentary groups. Active group practiced regular adapted physical exercise at least 150min/week divided in at least 3 days/week for at least 3 consecutive months.

Outcome Measures: Total BMC; BMD of total body, lumbar spine, total proximal femur, femoral neck and 33% radius; serum calcium; serum intact PTH; 25-hydroxyvitamin D (25(OH)D); insulin-like growth factor-1; OC; type I collagen.

1.    After adjusting for TPI, total body mass and calcium intake, no differences were observed between groups for any bone parameter except for the lumbar spine BMD, which was significantly higher in the sedentary group.

2.    Serum concentrations of total calcium, 25(OH)D, insulin-like growth factor-1 and PTH were on average within normal range and were similar between sedentary and active groups.

3.    In active subjects, serum concentrations of 25(OH)D were associated positively with hours of physical exercise per week (r=0.59). Serum concentrations of PTH were associated negatively with hours of physical exercise per week (r=-0.50).

4.    No significant associations between habitual calcium intake and bone parameters were observed for the whole group.

* All data expressed as mean±SD, unless expressed otherwise.