Please use this identifier to cite or link to this item: http://hdl.handle.net/2440/23218
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Type: Journal article
Title: Physiological effects of lower extremity functional electrical stimulation in early spinal cord injury: lack of efficacy to prevent bone loss
Author: Clark, J.
Jelbart, M.
Rischbieth, H.
Strayer, J.
Chatterton, B.
Schulz, C.
Marshall, R.
Citation: Spinal Cord, 2007; 45(1):78-85
Publisher: Nature Publishing Group
Issue Date: 2007
ISSN: 1362-4393
1476-5624
Statement of
Responsibility: 
J M Clark, M Jelbart, H Rischbieth, J Strayer, B Chatterton, C Schultz and R Marshall
Abstract: STUDY DESIGN: Controlled, repeat-measures study. OBJECTIVES: To determine if functional electrical stimulation (FES) can affect bone atrophy in early spinal cord injury (SCI), and the safety, tolerance and feasibility of this modality in bone loss remediation. SETTING: Spinal Injuries Units, Royal Adelaide Hospital and Hampstead Rehabilitation Centre, South Australia. METHODS: Patients with acute SCI (ASIA A-D) were allocated to FES (n=23, 28+/-9 years, C4-T10, 13 Tetra) and control groups (CON, n=10, 31+/-11 years, C5-T12, four Tetra). The intervention group received discontinuous FES to lower limb muscles (15 min sessions to each leg twice daily, over a 5-day week, for 5 months). Dual energy X-ray absorptiometry (DEXA) measured total body bone mineral density (tbBMD), hip, spine BMD and fat mass (FM) within 3 weeks, and 3 and 6 months postinjury. RESULTS: FES and CON groups' tbBMD differed significantly at 3 months postinjury (P<0.01), but not thereafter. Other DEXA measures (hip, spine BMD, FM) did not differ between groups at any time. No adverse events were identified. CONCLUSION: Electrically stimulated muscle activation was elicited, and tetanic effects were reproducible; however, there were no convincing trends to suggest that FES can play a clinically relevant role in osteoporosis prevention (or subsequent fracture risk) in the recently injured patient. The lack of an osteogenic response in paralysed extremities to electrically evoked exercise during subacute and rehabilitation/recovery phases cannot be fully explained, and may warrant further evaluation.
Keywords: osteoporosis; bone mineral density; exercise; bone physiology
Description: © 2008 International Spinal Cord Society
Provenance: Published online 25 April 2006
RMID: 0020070092
DOI: 10.1038/sj.sc.3101929
Published version: http://www.nature.com/sc/journal/v45/n1/abs/3101929a.html
Appears in Collections:Orthopaedics and Trauma publications

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