title: Effects of cycling and/or electrical stimulation on bone mineral density in children with spinal cord injury.
abstract: METHODS
  Randomized clinical trial.
  
  
  OBJECTIVE
  To determine the effect of cycling and/or electrical stimulation on hip and knee bone mineral density (BMD) in children with spinal cord injury (SCI).
  
  
  METHODS
  Children's hospital specializing in pediatric SCI.
  
  
  METHODS
  A total of 30 children, aged 5-13 years, with chronic SCI were randomized to one of three interventions: functional electrical stimulation cycling (FESC), passive cycling (PC), and non-cycling, electrically stimulated exercise (ES). Each group exercised for 1 h, three times per week for 6 months at home. The hip, distal femur and proximal tibia BMD were examined via dual-energy X-ray absorptiometry (DXA) pre- and post-intervention.
  
  
  RESULTS
  In all, 28 children completed data collection. The FESC group exhibited increases in hip, distal femur and proximal tibia BMD of 32.4, 6.62 and 10.3%, respectively. The PC group exhibited increases at the hip (29.2%), but no change at the distal femur (1.5%) or proximal tibia (-1.0%). The ES group had no change at the hip (-0.24%) and distal femur (3.3%), but a loss at the proximal tibia (-7.06%). There were no differences between groups or within groups over time. Significant negative correlations were found between baseline BMD and the amount of BMD change.
  
  
  CONCLUSIONS
  Although not achieving statistical significance, hip BMD changes observed were greater than the reported 0.9-10% gains after exercise for children with and without disability. Thus, cycling with and without electrical stimulation may be beneficial for skeletal health in pediatric SCI, but further research is needed with a larger sample size.
authors.affiliation: Department of Physical Therapy, Temple University, Philadelphia, PA, USA.
authors.forename: R T
authors.initials: RT
authors.lastname: Lauer
authors.forename: B T
authors.initials: BT
authors.lastname: Smith
authors.forename: M J
authors.initials: MJ
authors.lastname: Mulcahey
authors.forename: R R
authors.initials: RR
authors.lastname: Betz
authors.forename: T E
authors.initials: TE
authors.lastname: Johnston
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000704:Analysis of Variance; D001642:Bicycling / Q000502:physiology; D015519:Bone Density / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D012044:Regression Analysis; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome