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Robotic Walking to Mitigate Bone Mineral Density Decline and Adverse Body Composition in Individuals With Incomplete Spinal Cord Injury ; A Pilot Randomized Clinical Trial

Title: Robotic Walking to Mitigate Bone Mineral Density Decline and Adverse Body Composition in Individuals With Incomplete Spinal Cord Injury ; A Pilot Randomized Clinical Trial
Authors: Shackleton, Claire; Evans, Robert; West, Sacha; Derman, Wayne; Albertus, Yumna
Source: American Journal of Physical Medicine & Rehabilitation ; volume 101, issue 10, page 931-936 ; ISSN 1537-7385 0894-9115
Publisher Information: Ovid Technologies (Wolters Kluwer Health)
Publication Year: 2021
Description: Objective The aim of the study was to determine whether 24 wks of robotic locomotor training or activity-based training was sufficient time to induce bone mineral density and body composition changes in individuals with spinal cord injury. This study reports the secondary analysis of a randomized pilot trial. Design Participants with chronic motor incomplete tetraplegia ( N = 16) were recruited. Interventions involved 60-min sessions, 3× per week, over 24 wks. Robotic locomotor training involved walking in the Ekso GT suit. Activity-based training involved a combination of resistance, cardiovascular, and weight-bearing exercise. Results Hip bone mineral density was maintained during robotic locomotor training; however, it was significantly reduced ( P = 0.04, effect size = 0.86) during activity-based training by 0.03 (−0.29 to 0.23) g/cm 2 after intervention. Both interventions improved arm fat-free soft tissue mass, but neither group experienced changes in leg fat-free soft tissue mass. The activity-based training group had a significant decrease in visceral adipose tissue ( P = 0.04, effect size = 0.72) and gynoid fat mass ( P = 0.01, effect size = 0.62). Conclusions Twenty-four weeks of robotic locomotor training is possibly a sufficient duration to prevent the progressive decline of bone mineral density usually occurring in this population. A longitudinal period of activity-based training serves as an effective rehabilitation strategy to reduce indices of fat mass in individuals with spinal cord injury.
Document Type: article in journal/newspaper
Language: English
DOI: 10.1097/phm.0000000000001937
DOI: 10.1097/PHM.0000000000001937
Availability: https://doi.org/10.1097/phm.0000000000001937; https://journals.lww.com/10.1097/PHM.0000000000001937
Accession Number: edsbas.37B19177
Database: BASE