Early intervention to reduce bone loss after spinal cord injury
Research type
Research Study
Full title
An early detection and intervention strategy to delay the onset of osteoporosis and reduce fracture incidence after spinal cord injury
IRAS ID
84046
Contact name
Sylvie Coupaud
Contact email
Sponsor organisation
University of Strathclyde
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
The proposed study is related to a completed study "Longitudinal study of bone demineralisation following spinal cord injury using peripheral Quantitative Computed Tomography (pQCT)" (REC Ref: 05/S0702/131). After a complete paraplegia or tetraplegia, rapid muscle atrophy is often accompanied by extensive bone loss in the paralysed limbs. Decreases in bone mineral density in the first year of spinal cord injury (SCI) can reach 20-50% at fracture-prone sites. However, rates of bone loss are highly variable in SCI, and our recently-completed reference study suggests that patients with SCI can be categorised as "FAST" or "SLOW" bone losers within a few months of injury. By implementing protocols to identify individuals with accelerated rates of bone loss early on, clinicians could target osteoporosis interventions towards those who need them most. Therefore, an early detection and early intervention strategy will be investigated in SCI, to achieve (i) detection of the onset of osteoporosis in the acute phase; (ii) early intervention aimed at reducing rates of bone loss; and (iii) monitoring of the effectiveness of a bone-stimulating rehabilitation intervention. Rates of bone loss between baseline and repeat scans at 4-months post-SCI will be used to stratify patients to "FAST" or "SLOW" bone loss groups. All participants identified as FAST bone losers (1% or more decrease in BMD per month, equivalent to 12% per year) will be offered a 4-month programme of whole body vibration (WBV) intervention. Repeat scans at 8-months post-SCI will reveal the effectiveness of the intervention. For accuracy, peripheral Quantitative Computed Tomography will be used to quantify changes in bone initially in the absence of intervention, and then in response to rehabilitation intervention. The emerging rehabilitation intervention of WBV will be compared against standard techniques (standing frame, tilt table), to determine its effectiveness in maintaining bone health in the early stages of SCI.
REC name
West of Scotland REC 3
REC reference
15/WS/0009
Date of REC Opinion
6 Feb 2015
REC opinion
Further Information Favourable Opinion