Summary
Submitted by admin on Wed, 05/19/2010 - 13:46
- There is level 1 evidence (from 3 RCTs) (Minaire et al. 1981, 1987; Chappard et al. 1995) that oral Tiludronate and Clodronate prevent a decrease in BMD of the hip and knee region with no adverse effects on bone mineralization in men with paraplegia.
- There is level 1 (from 1 RCT) (Pearson et al. 1997) that oral Etidronate prevents a decrease in BMD of the hip and knee region in people with incomplete paraplegia or tetraplegia (AIS D impairment) who return to walking within 3 months of the SCI.
- There is level 1 evidence (from 1 RCT) (Gilchrist et al. 2007) that once weekly oral Alendronate maintains BMD at the hip.
- There is level 1 evidence (from 1 RCT) (Shapiro et al. 2007) once yearly IV Infusion Zoledronate does not prevent a decline in hip region BMD at 12 months among patients with motor complete injuries
- There is level 1 evidence (from 1 RCT) (Bauman et al. 2005) that Pamidronate 60mg IV seven times per year and level 2 evidence (from 1 non-randomized prospective controlled trial) (Nance et al. 1999) that Pamidronate 30 mg IV six times per year is not effective for the prevention of BMD loss at the hip and knee region early after SCI in men and women who have motor complete paraplegia or tetraplegia.
- There is level 1 evidence (from 1 RCT) (Zehnder et al. 2004) that Alendronate 10 mg daily and Calcium 500mg orally 3x/day is effective for the maintenance of BMD of the total body, hip and knee region for men with paraplegia.
- There is level 1 evidence (from 1 RCT) (Bauman et al. 2005b) that vitamin D analog is effective for maintaining leg BMD.
- There is level 1 evidence (from one RCT) (Warden et al. 2001) that short-term (6 weeks) ultrasound is not effective for treating bone loss after SCI.
- There is level 2 evidence (from 1 non-randomized prospective controlled trial) (Shields et al. 2006a) that ES reduced the decline in BMD in the leg.
- There is level 2 evidence (from 1 non-randomized prospective controlled trial) (Eser et al. 2003) that FES-cycling did not improve or maintain bone at the tibial midshaft in the acute phase.
- There is level 4 evidence (from 1 pre-post study) (Giangregorio et al. 2005) that walking and level 1 evidence (from 1 RCT) (Ben et al. 2005) that standing in the acute phase did not differ from immobilization for bone loss at the tibia.
- There is level 2 evidence (from 1 prospective controlled trial) (Bélanger et al. 2000) that electrical stimulation either increased or maintained BMD over the stimulated areas
- There is level 4 evidence (from 1 pre-post study) (Melchiorri et al. 2007) that vibration training did not improve or maintain BMC in the arms.
- There is level 4 evidence that FES cycle ergometry of at least 6 months duration may increased regional lower extremity BMD over areas stimulated.
- There is inconclusive evidence for Reciprocating Gait Orthosis, long leg braces, passive standing or self-reported physical activity as a treatment for low bone mass.
