The effect of Functional Electrical Stimulation-assisted posture-shifting in bone mineral density: case series-pilot...

Area of Science:

• Biomedical Engineering
• Neuroscience
• Orthopedics

Background:

• Spinal cord injury (SCI) often leads to bone loss, increasing fracture risk.
• Maintaining bone mineral density (BMD) is crucial for individuals with SCI.
• Current interventions for bone loss in SCI have limited efficacy.

Purpose of the Study:

• To investigate the impact of a novel training intervention using standing dynamic load-shifting Functional Electrical Stimulation (FES) on bone mineral density (BMD) in individuals with complete SCI.
• To assess changes in volumetric bone mineral density (vBMD) in the distal femur and tibia following FES-assisted exercises.

Main Methods:

• A training intervention study involving individuals with complete SCI (ASIA A, T2-T10).
• Participants underwent FES-assisted dynamic load-shifting exercises and FES knee extension exercises for approximately 29 weeks.
• Volumetric Bone Mineral density (vBMD) was measured using peripheral quantitative computed tomography (pQCT) pre- and post-intervention.

Main Results:

• Significant absolute increases in trabecular vBMD (vBMD_TRAB) were observed in the proximal tibia (mean 26.9%) and distal tibia (mean 22.35%) in participants with acute and subacute SCI.
• Loss of vBMD_TRAB was noted in the distal femur, as expected.
• Improvements in tibial vBMD were observed in participants who combined high- and lower-intensity FES-assisted exercises.

Conclusions:

• FES-assisted dynamic load-shifting exercises can improve tibial bone mineral density in individuals with acute and subacute SCI.
• Combining high- and lower-intensity FES-assisted exercises appears to be an effective strategy for enhancing bone health in SCI.
• Further research is warranted to optimize FES interventions for preventing bone loss and reducing fracture risk in the SCI population.