Citation

Shackleton C, Evans R, West S, Derman W, Albertus Y. Am. J. Phys. Med. Rehabil. 2021; ePub(ePub): ePub.

Copyright

(Copyright © 2021, Lippincott Williams and Wilkins)

DOI

10.1097/PHM.0000000000001937

PMID

34864766

Abstract

OBJECTIVE: To determine whether 24 weeks of Robotic Locomotor Training (RLT) or Activity-based Training (ABT) was sufficient time to induce bone mineral density (BMD) and body composition changes in individuals with spinal cord injury (SCI). This study reports the secondary analysis of a randomised pilot trial.

DESIGN: Participants with chronic motor incomplete tetraplegia (n = 16) were recruited. Interventions involved 60-minute sessions, 3x per week, over 24-weeks. RLT involved walking in the Ekso GT suit. ABT involved a combination of resistance, cardiovascular and weight-bearing exercise.

RESULTS: Hip BMD was maintained during RLT; however, it was significantly reduced (p = 0.04; Effect size (ES) = 0.86) during ABT by 0.03 [-0.29, 0.23] g/cm2 post intervention. Both interventions improved arm fat-free soft tissue mass (FFSTM), but neither group experienced changes in leg FFSTM. The ABT group had a significant decrease in visceral adipose tissue (p = 0.04; ES = 0.72) and gynoid fat mass (FM) (p = 0.01; ES = 0.62).

CONCLUSIONS: 24 weeks of RLT is possibly a sufficient duration to prevent the progressive decline of BMD usually occurring in this population. A longitudinal period of ABT serves as an effective rehabilitation strategy to reduce indices of FM in individuals with SCI.

Language: en