Bone mineral density after spinal cord injury: a reliable method for knee measurement.

摘要: Osteoporosis is a severe and debilitating secondary complication of complete spinal cord injury (SCI). Bone mineral density (BMD) the paralyzed extremities declines precipitously in first 2 years after SCI, eventually reaching level below fracture threshold.1-4 Between 1% 6% people with SCI will sustain fractures their extremities.5-7 Fractures are often caused by trivial insults to limbs5,7,8 that frequently encounter during everyday mobility. The main instrument used measure BMD dual-energy x-ray absorptiometry (DXA). In postmenopausal women, DXA-based T scores diagnose osteoporosis technique valuable for monitoring longitudinal changes bone density. The progression has been described hip lumbar spine. general, rapidly several months, then more slowly until equilibrium at 12 16 months postinjury.1,2,4 Lumbar spine generally does not decline may even increase SCI.4,9 By far most common sites distal femur proximal tibia.5,7,10 those have times risk developing than without an SCI. Because tibia commonly able-bodied population, specified protocols these regions available. Previous studies array protocols, usually addressing reliability methods used. Many lack important methodologic details, such as type DXA scan algorithm (forearm or spine), how region interest (ROI) was determined,10-12 whether procedures reproducible.11,12 One previous study13 adequately details; however, researchers did establish procedure. Because definitive knee exist, it remains unclear manner similar other sites, development follows different time course. Moreover, z do exist.10 Therefore, clinical estimation possible. Rehabilitation specialists routinely make decisions regarding loading standing,14 electric stimulation,15,16 suspended treadmill training,17 various rehabilitative transfer techniques. prevalence post-SCI about knee, reliable method determine rehabilitation working SCI. We operationally defined protocol analyze interrater method. We compared hip, spine, controls. Finally, we examined relation between measurements