Physical therapy

Author: SCIRE Community Team | Reviewer: B. Catharine Craven | Published: 11 October 2017 | Updated: 14 March 2019

There are a number of physical treatment options that have been proposed for preventing and treating bone loss after SCI, however, the evidence does not support their regular use in treating bone loss after SCI.

FES can be applied to the leg muscles during assisted walking.¹¹

Functional electrical stimulation (FES) is a treatment that applies electrical stimulation to the muscles during activities like standing, walking, or cycling. This treatment involves repeated pulling of the muscles on bones, which could help to strengthen the bones.

There is evidence suggesting that functional electrical stimulation cycling does not prevent bone loss in the lower leg early after SCI but may help to increase bone mineral density in stimulated areas of the leg during the later period after SCI. However, the stimulation needs to be ongoing or the benefits will be lost.

SCIRE Community provides additional detailed information about FES following SCI.

Electrical stimulation to the muscles without functional activities may also be used. There is evidence suggesting that electrical stimulation can maintain or increase bone density over the stimulated areas. However, other studies have shown that the effects of electrical stimulation may return to baseline density within a few months after the treatment has ended.

More research is needed to support weight-bearing activities for osteoporosis prevention.¹²

Weight-bearing activities are activities where the weight of the body is supported through the bones. Weight-bearing has long been considered to have an important role in bone health because it causes compression of the bones that may stimulate bone strengthening.

Weight-bearing treatments after SCI may include a variety of standing and walking activities, such as standing frames, braces, standing with functional electrical stimulation, and treadmill training.

Current evidence for weight-bearing activities for maintaining or improving bone health after SCI is inconclusive and needs further study.

Physical activity is thought to improve bone health through a variety of processes that cause an increase in bone density. However, there is currently no evidence to support physical activity as a treatment for low bone density after SCI.

Therapeutic ultrasound

Therapeutic ultrasound is a treatment that uses ultrasonic waves to provide energy to tissues deep within the body. Scientists have studied whether this treatment could provide stimulation to the bones to help prevent bone loss after SCI. However, current evidence suggests that therapeutic ultrasound is not effective for preventing bone loss after SCI.

Vibration exercise

Vibration exercise is a treatment that involves mechanical vibration of the body during resistance exercises. Current evidence suggests that vibration training is not effective for treating bone loss in the arms after SCI.