Journal of Rehabilitation Research & Development (JRRD)

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JRRD Volume 46, Number 8, 2009

Volume 46 Number 8, 2009
   Pages 1034 — 1044

Abstract — Influence of neurological level of injury in bones, muscles, and fat in paraplegia

Yannis Dionyssiotis, MD, PhD;1* George P. Lyritis, MD, PhD;2 Nikolaos Papaioannou, MD, PhD;2 Panagiotis Papagelopoulos, MD, PhD;2 Thomas Thomaides, MD, PhD3

1Rehabilitation Department, General Hospital of Rhodes, Rhodes, Greece; 2Laboratory for Research of the Musculoskeletal System, University of Athens, Kifissia, Greece; 3Neurologic Department, Red Cross Hospital, Athens, Greece

Abstract — To investigate the influence of the neurological level of injury in bone mineral content (BMC) and mechanical properties, lean mass (LM), and fat mass (FM) among paraplegics with a similar duration of paralysis (DOP), we separated 30 paraplegics into group A (15 men, high-level paraplegia) and group B (15 men, low-level paraplegia) and compared them with group C (33 men, nondisabled). In all subjects, we measured stress-strain index (SSI) at 14% (SSI2) and 38% (SSI3) of the tibia length and the difference between them using peripheral quantitative computed tomography (XCT 3000 [Stratec Medizintechnik, Pforzheim, Germany]) and lower-limb BMC, LM, and FM (g) using whole-body dual-energy X-ray absorptiometry (Norland XR-36 [Norland Medical Systems, Inc; Fort Atkinson, Wisconsin]). Bone strength parameters, BMC, and LM were statistically decreased, but we found no difference in paraplegic FM compared with group C. We found a correlation between the DOP and the difference between SSI3 and SSI2 in group B (r = 0.53, p = 0.03 and r = 0.5, p = 0.04, respectively). We correlated DOP with FM in group A's lower limbs (r = 0.5, p = 0.05). Because of the nonsignificant DOP, the groups with paraplegia act differently in tibia mechanical properties and lower-limb body composition.

Key words: bone, bone mineral content, bone strength, dual-energy X-ray absorptiometry, fat mass, lean mass, lower limb, men, paraplegia, peripheral quantitative computed tomography.

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