Effect of Progressive Locomotor Treadmill Compared to Conventional Training on Bone Mineral Density and Bone Remodeling in Paraplegia

Abstract

Background: The decrease in bone mass in paraplegic spinal cord injured persons increases the risk factors for fractures. Objectives: The aim of the present study was to evaluate the effects of progressive locomotor treadmill training (LT) on muscle mass, bone mineral density, and bone remodeling in paraplegia patients. Methods: The subjects investigated in this research included seventeen paraplegic spinal cord injured persons who were divided randomly into two groups: LT group (n = 10) and conventional exercise group (n = 7). The exercise training protocol was performed during 12 weeks, 3 days a week, 60 minutes a session. LT included 15 minutes warm-up on stationary bike plus 45 minutes LT with 50 percent body-weight support and finally 10 minutes cool-down as an adjunct to a conventional physiotherapy program. 10 percent loading weight was added per week for LT. Conventional exercise training incorporated 15 minutes warm-up plus 45 minutes over-ground training such as stretch exercise and resistance training. Results: The obtained results showed that there were significant differences in serum alkaline phosphatase levels (P < 0.001), osteocalcin levels (P = 0.003), bone mineral content (BMC) of the femoral neck (P < 0.001), bone mineral density (BMD) of femoral neck (P < 0.001), bone mineral content (BMC) of the lumbar spine (P < 0.001), and bone mineral density (BMD) of the lumbar spine (P = 0.000) between LT and conventional exercise regimes. Conclusions: LT training, in addition to improvement of motor function and reduction of bone loss, can be prescribed as an effective exercise intervention for the treatment of osteoporosis in incomplete spinal cord injured persons.