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Bone loss and muscle atrophy in spinal cord injury: epidemiology, fracture prediction, and rehabilitation strategies.

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TLDR
A number of interventions, including standing, electrically stimulated cycling or resistance training, and walking exercises have been explored with the aim of reducing bone loss and/or increasing bone mass and muscle mass in individuals with spinal cord injury as mentioned in this paper.
Abstract
Individuals with spinal cord injury (SCI) often experience bone loss and muscle atrophy Muscle atrophy can result in reduced metabolic rate and increase the risk of metabolic disorders Sublesional osteoporosis predisposes individuals with SCI to an increased risk of low-trauma fracture Fractures in people with SCI have been reported during transfers from bed to chair, and while being turned in bed The bone loss and muscle atrophy that occur after SCI are substantial and may be influenced by factors such as completeness of injury or time postinjury A number of interventions, including standing, electrically stimulated cycling or resistance training, and walking exercises have been explored with the aim of reducing bone loss and/or increasing bone mass and muscle mass in individuals with SCI Exercise with electrical stimulation appears to increase muscle mass and/or prevent atrophy, but studies investigating its effect on bone are conflicting Several methodological limitations in exercise studies with individuals with SCI to date limit our ability to confirm the utility of exercise for improving skeletal status The impact of standing or walking exercises on muscle and bone has not been well established Future research should carefully consider the study design, skeletal measurement sites, and the measurement techniques used in order to facilitate sound conclusions

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Journal ArticleDOI

Chronic complications of spinal cord injury.

TL;DR: Data is reviewed about common secondary long-term complications after SCI, including respiratory complications, cardiovascular complications, urinary and bowel complications, spasticity, pain syndromes, pressure ulcers, osteoporosis and bone fractures.
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Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting.

TL;DR: The findings support the hypothesis that internal tissue loads are significantly higher in paraplegics, and that postural changes significantly affect these loads, and help quantify the effectiveness of various interventions to alleviate sub-dermal tissue loads at sites susceptible to pressure ulcers and DTI.
Journal ArticleDOI

Bone and muscle loss after spinal cord injury: organ interactions

TL;DR: Adiposity and marrow fat are increased after SCI with intriguing, though poorly understood, implications for the function of skeletal muscle and bone cells.
Journal ArticleDOI

Role of Oxidative Stress as Key Regulator of Muscle Wasting during Cachexia.

TL;DR: The importance of oxidative stress in skeletal muscles, its sources, and how it can regulate protein synthesis/degradation imbalance, autophagy deregulation, increased myonuclear apoptosis, and mitochondrial dysfunction involved in cachexia are described.
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Official positions of the International Society for Clinical Densitometry (ISCD) on DXA evaluation in children and adolescents

TL;DR: The International Society for Clinical Densitometry (ISCD) organized a Pediatric Position Development Conference to discuss the specific problems of bone densitometry in growing subjects and to provide essential recommendations for its clinical use.
References
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Assessment of fracture risk and its application to screening for postmenopausal osteoporos

TL;DR: There is little evidence that osteoporosis can usefully be tackled by a public health policy to influence risk factors such as smoking, exercise and nutrition, so the selective use of screening techniques will improve the cost-benefit ratio of intervention.
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Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group.

TL;DR: The criteria required for an effective screening strategy for osteoporosis are largely met in Caucasian women as mentioned in this paper, which suggests that it is appropriate to consider targetting of treatment with agents affecting bone metabolism to susceptible individuals.
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Osteoporosis after spinal cord injury

TL;DR: Dual‐photon absorptiometry characterized bone loss in males aged <40 years after complete traumatic paraplegic and quadriplegic spinal cord injury and demonstrated early, rapid, linear decline of bone below the pelvis.
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Quantitative histological data on disuse osteoporosis: comparison with biological data.

TL;DR: The histological and biochemical changes suggest an histodynamic hypothesis according to which the global lifespan of the BMU (Basic Multicellular Unit from Frost) would be increased, leading to a newsteady state: rarefied bone with a low rate of subsequent turn-over.
Journal ArticleDOI

Factors influencing body composition in persons with spinal cord injury: a cross-sectional study

TL;DR: Person with SCI were fatter for any body mass index and demonstrated significantly less lean and more adipose tissues for any given age compared with controls.
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