Thesis
Characterisation of bone loss and development of an electrostimulation intervention to improve bone health in adults with spinal cord injury
- Creator
- Rights statement
- Awarding institution
- University of Strathclyde
- Date of award
- 2023
- Thesis identifier
- T16630
- Person Identifier (Local)
- 201889694
- Qualification Level
- Qualification Name
- Department, School or Faculty
- Abstract
- Bone loss following spinal cord injury (SCI) is typically more rapid compared to that associated with aging or postmenopause, leading to high susceptibility to fragility fractures, subsequent health complications and reduced quality of life. Characteristics of this complex form of bone loss have not been fully studied or understood. Furthermore, most of the available rehabilitation approaches are limited by different factors ranging from the low muscle forces that are achievable to safety considerations. Therefore, the aims of this thesis were to develop a more detailedcharacterisation of bone loss in the paralysed limbs following SCI, and to assess the feasibility and effectiveness of a novel approach of Recruiting Antagonistic Muscle Pairs using Electrical Stimulation (RAMP-ES) to maximise the muscle forces produced and its potential to achieve bone stimulation. In this thesis, longitudinal bone loss in the fibula and the regional variation in bone loss across tibia cross-sections over twelve months following SCI were studied for the first time. Furthermore, RAMP-ES protocols were developed and tested in able-bodied participants before assessing the effectiveness of the novel approach on muscle and bone health in people with chronic SCI. Longitudinal loss in BMC and BMD in the fibula was found to be smaller compared to the tibia (-6.9±5.1% and -6.6± 6.0% vs -14.8 ±12.4% and -14.4±12.4%, p=0.02and p=0.03, respectively), in line with previous cross-sectional reports. In the tibia, bone loss was found to vary regionally in the diaphysis, with total loss at four months being a strong predictor of total loss after twelve months postinjury (r=0.84 and r=0.82 for 4% and 66% tibial sites, respectively, both P < 0.001). The novel RAMPES protocol was developed and tested in able-bodied participants and was found tobe practical. A four-month RAMP-ES training schedule improved muscle size (7.3-19.8%) and strength in people with chronic SCI, but it had no clear effect on bone density. These findings contribute a better characterisation of bone loss and showed that the RAMP-ES intervention can improve muscle health following SCI. More studies should be done to further assess or improve the effectiveness of RAMP-ES for bonehealth applications.
- Advisor / supervisor
- Ireland, Alex
- Coupaud, Sylvie
- Kerr, Andrew, Ph. D.
- Purcell, Mariel
- Resource Type
- DOI
- Date Created
- 2022
Relações
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PDF of thesis T16630 | 2023-06-20 | Público | Baixar |