Exercise and Activity-Based Physiotherapy for Bone Health After SCI : A Review of Evidence

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A spinal cord injury (SCI) is damage to the bundle of nerves and nerve fibers that sends and receives signals from the brain. The spinal cord extends from the lower part of the brain down through the lower back.
Spinal cord injury (SCI) can have a significant impact on bone health. Due to reduced physical activity and muscle paralysis, people with SCI are at increased risk for osteoporosis and fractures.
Exercise and activity-based physical therapy (ABPT) can help to improve bone health in people with SCI by:
• Reducing bone loss: Exercise helps to stimulate bone formation and reduce bone resorption.
• Improving muscle strength: Strong muscles help to protect bones and reduce the risk of falls.
• Improving balance and coordination: This can help to reduce the risk of falls and fractures.
There are a variety of different exercise and ABPT modalities that can be used to improve bone health in people with SCI. Some of the most common include:
• Functional electrical stimulation (FES): FES uses electrical currents to stimulate muscle contractions. This can be used to exercise paralyzed muscles and improve bone loading.
• Body weight supported treadmill training (BWSTT): BWSTT allows people with SCI to walk or run on a treadmill while being supported by a harness. This can help to improve bone loading and muscle strength.
• Resistance training: Resistance training can be used to strengthen muscles throughout the body, including the paralyzed muscles. This can help to improve bone health and reduce the risk of falls and fractures.
The type and intensity of exercise or ABPT that is appropriate for a person with SCI will depend on their individual level of function and injury severity. It is important to work with a qualified healthcare professional to develop a safe and effective exercise program.
Research on the effects of exercise and ABPT on bone health in people with SCI is still ongoing. However, the available evidence suggests that exercise and ABPT can help to reduce bone loss and improve bone health.
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