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

The decrease in bone mass in paraplegic spinal cord injured persons increases the risk factors for fractures.

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.

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.

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.

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.