Bone Health Improvement in Individuals with SCI
Research type
Research Study
Full title
Bone Health Improvement in Individuals with Spinal Cord Injury using FES
IRAS ID
216159
Contact name
William Holderbaum
Contact email
Sponsor organisation
University of Reading
Duration of Study in the UK
1 years, 8 months, 21 days
Research summary
Following spinal cord injury (SCI) there is an increased risk of low bone mineral density (BMD), particularly in the lower limbs. Low BMD is associated with an increased risk of sub-lesional fracture. Lower extremity fracture may result in long-term hospital stays and is associated with an increased risk of mortality in males with SCI.\nBones adapt to the pattern of forces they are placed under, and it is estimated that the threshold of force needed to elicit bone adaptation (>1.5x body weight or >20MPa). In the general population this is often achieved through weight bearing exercise, consistent with NHS guidelines of weight bearing exercise to prevent osteoporosis (decreased BMD). However, due to paralysis in SCI, traditional forms of weight bearing exercise may not be possible. Functional electrical stimulation (FES) provides a method of producing controlled movement in people with paralysis.\nElectrodes are attached over the skin above targeted muscles. An electric current is then passed through the electrode causing the underlying muscle to contract (activate). By controlling the timing of the currents passed through different electrodes it is possible to activate muscles in a specific order to produce a desired movement. This research aims to improve bone health in SCI patients. This will be achieved by completing a series of suitable repeatable load bearing exercises which elicit bone adaptation. These exercises are based on pilot tests, on healthy and one SCI subject, which produced sufficient joint contact forces in lower limb joints (ankle, knee and hip) .\nExercises will be completed using a novel standing frame and functional electrical stimulation (FES) to cyclically activate different sets of muscles whilst maintaining standing position. Biomechanical modelling of movements and external forces, will allow designing a novel rehabilitation program to improve bone health. \nBone health will be assessed by doing pQCT scans.
REC name
South West - Central Bristol Research Ethics Committee
REC reference
17/SW/0186
Date of REC Opinion
8 Sep 2017
REC opinion
Further Information Favourable Opinion