Evaluation of a training program for persons with SCI paraplegia using the Parastep 1 ambulation system: part 3. Lack of effect on bone mineral density

Arch Phys Med Rehabil. 1997 Aug;78(8):799-803. doi: 10.1016/s0003-9993(97)90190-8.


Objective: To determine if the bone mineral density loss seen after spinal cord injury (SCI) is reversed by a walking program using the Parastep 1 system.

Design: Before-after trial.

Setting: Human SCI applied research laboratory.

Participants: Thirteen men and 3 women with thoracic motor- and sensory-complete SCI, mean age 28.8yrs, mean duration postinjury 3.8yrs.

Intervention: Thirty-two functional neuromuscular stimulation (FNS) ambulation training sessions using a commercially available system (Parastep 1). This system consists of a microprocessor-controlled stimulator and a modified walking frame with finger-operated switches that permit the user to control the stimulation parameters and activate the stepping.

Outcome measure: Bone mineral density at the femoral head, neck, and Ward's triangle measured using a Lunar DP3 dual-photon densitometer.

Results: No significant change in bone mineral density was found using repeated measures analyses of variance.

Conclusions: Axial loading combined with muscle stimulation and resistive exercise does not result in significant changes in bone mineral density in persons with complete paraplegia.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Bone Density*
  • Electric Stimulation Therapy / standards*
  • Female
  • Humans
  • Male
  • Microcomputers
  • Middle Aged
  • Osteoporosis / diagnostic imaging*
  • Osteoporosis / etiology
  • Paraplegia / etiology
  • Paraplegia / rehabilitation*
  • Program Evaluation
  • Radionuclide Imaging
  • Spinal Cord Injuries / complications*
  • Therapy, Computer-Assisted / standards*
  • Walking
  • Weight-Bearing