Page 1 of 2 12 LastLast
Results 1 to 10 of 13

Thread: how much weightbearing?

  1. #1
    Senior Member
    Join Date
    Jul 2001
    Location
    Boca Raton, Florida, USA
    Posts
    1,451

    how much weightbearing?

    Ok, this may come as a shock, but I have NO IDEA whether or not I'm getting sufficient weightbearing on my bones to prevent osteoporosis. How much do I need? Has any research been done with people with spinal cord injuries which would show how much standing is sufficient?

    For CERTAIN this would differ from someone who get's around the world walking. How much is needed to prevent it? How much and at what application levels can it be fixed?

    None of this data was presented to me in rehab. It should be, no question about it. It's all very nice that I can stand on my head in a wheelchair...

    [This message was edited by Eric Texley on Jun 06, 2002 at 12:52 PM.]

  2. #2
    Eric,

    There are no clear guidelines concerning standing and there is still disagreement amongst rehab doctors whether standing really does reduce osteoporosis. In any case, most places usually do not recommend more than an hour or standing. I think that a person should start with only 5-10 minutes and gradually increase it to an hour a day over several weeks.


    Wise.

  3. #3
    Senior Member
    Join Date
    Jul 2001
    Location
    Boca Raton, Florida, USA
    Posts
    1,451

    Calcium Resorption

    It seems to me that this would be a good study to do...specifically take 100 spinal cord injury patients and give them different standing, estim, and exercise regimen, and find out what is the most effective of preventing the onset of osteoporosis.

    From what I've ready, there is a benign radioactive tracer than can be taken. With measurement tools, the distribution of calcium throughout the body can be studied. The half life of the irradiated calcium is 10,000 years, and it's harmless. It's already being used in women, and it seems like it would help SCI patients alot.

    Eric Texley

  4. #4
    I agree. Unfortunately, the technique that you mentioned is expensive. Most people use CT-scan or x-rays to measure calcium levels in the bone and, as you suggest, they are not particularly good for assessing restoration of bone. In fact, greater calcium (which is what the x-rays detect) means more brittle bones. Wise.

  5. #5
    Senior Member
    Join Date
    Aug 2001
    Location
    Glenelg,Maryland USA
    Posts
    230
    Those of us who had Kao's surgery stand for an hour twice a day,not onl for our bones but to learn balance.I do not see how standing can hurt you so why not stand as much as you can

  6. #6
    Brians,

    I agree with one caveat. People should be careful to ramp up to 1-2 hours of standing over several weeks. People should understand that their skin, bones, and muscles are not use to holding up the weight and they must gradually increase the time. Overdoing it can lead blisters, sores, and even broken bones. Use common sense.

    Wise.

  7. #7
    Senior Member
    Join Date
    Jul 2001
    Location
    Boca Raton, Florida, USA
    Posts
    1,451

    Parathyroid

    Another possibility would be to measure the rate of calcium excretion in both urine as well as fecal matter without and with weight bearing activity.

    My understanding is that is was proven back in the first days of skylab and MIR that weight bearing causes parathroid to be released. This is what stimulates the cells to resorb.

    Can the amount of active parathyroid be measured?

    Also...I read that increased rate of calcium excretion in the urine can contribute to the occurence of kidney stones!!!! Standing every day for some period of time is probably the most theraputic thing that we do, isn't it.

    Eric Texley

  8. #8
    I´m afraid that standing doesnt prevent osteoporosis. Two of my quad friends was recently diagnosed with severe osteoporosis. One of them is a _walking_ quad (C7), the other, C4 complete, has been standing for an hour a day since rehab. There seem to be some other factor than lack of weightbearing that causes osteoporosis, at least in quads.

  9. #9
    Senior Member
    Join Date
    Jul 2001
    Location
    Boca Raton, Florida, USA
    Posts
    1,451
    There are several factors which come into play in prevention of osteoporosis. A very important one is diet...your diet must contain sufficient calcium and vitamin D.

    PTH (parathyroid hormone) stimulates the cells to resorb calcium. Weight bearing is an important factor for causing the presence of this hormone in the body. Another would be the muscles pulling on the bone. This can be accomplished with electrical stimulation...and you don't need a 10,000 dollar bicycle to do it. A cheap stim unit will accomplish this...and you CAN do weight bearing exercises with a cheap stim unit.

    I try to stand every day by applying stimulation to my quads. During the off intervals, someone can lock my knees for me. I can try to accomplish improvements in recruitment this way.

    What needs to be done is a study of the effects of these activities over a long term on wheelchair bound people. We need clinical data which says what activities and for how long we should do them...1) To maintain bone mass. 2) To recover brittle bones. I would think this should be done in conjuction with cure research, as it will effect the long term outcomes of any cure protocol which is administered.

    I've been doing some reading on the web concerning this topic...it appears that by simply measuring calcium concentrations in the urine and the fecal matter, one can determine whether or not calcium resorption is occuring...i.e. whether or not osteoporosis is setting in.

    http://lifesci.arc.nasa.gov/lis/Hard.../primate4.html

    This link points to a device which was used to do this for astronaughts during space flight.

    "
    Calcium: Calcium concentrations from samples and knowledge of total urine quantity on a related timeline provide the basis for calculating the total calcium excretion through urine during the mission. Calcium in the sample is detected optically after mixing with a chemical reagent, calcein, which produces a fluorescent complex, the intensity of which is an indicator of concentration.
    "

    I wonder how difficult it would be to convince an outpatient treatment center to perform this study if the proper protocols were followed?

    Eric Texley

  10. #10
    Senior Member
    Join Date
    Jul 2001
    Location
    Boca Raton, Florida, USA
    Posts
    1,451

    Space study!

    Then again...wouldn't the same data that was taken for astronaughts during space flight be an almost identical model of the lower body of wheelchair bound people?

    Eric Texley

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •