From paralysis to osteoporosis – keeping bones strong
This research was completed on 30 September 2009
Published on 6 October 2006
People who’ve been paralysed after injuring their spinal cord are at increased risk of breaking a bone, even if they’re confined to a wheelchair. Researchers are investigating ways to keep bones strong. The new treatments they’re developing may also help the seven million people in the UK who suffer from osteoporosis.
What's the problem and who does it affect?
Paralysed people are vulnerable to fractures
Some 40,000 people in the UK are paralysed after injuring their spinal cord.1 An estimated seven million have osteoporosis.2,3 These two very different groups of people have one important thing in common – they are all at increased risk of breaking a bone.
Spinal injuries happen without warning, typically through accidents on our roads or when playing sports. Survivors must suddenly face up to the devastating news that they’ve been paralysed.
Immediately after an injury to the spinal cord, the body starts to lose bone at an unprecedented rate. Within the first one or two years of their injury, some people lose a shocking 50 per cent of their bone mass at key sites such as the hip and knee.4
No-one knows how to restore bone density when it is lost on this scale, so patients who learn to walk again are at high risk of suffering a fracture. Indeed, bones can become so fragile that they break during movements that normally seem very safe, such as turning over in bed. Researchers hope that finding a way to prevent bone loss after paralysis might also help the vast numbers of older people who suffer from the more common form of osteoporosis.
What is the project trying to achieve?
Investigating ways to prevent bone loss
Researchers are giving patients who have recently injured their spinal cord three different treatments:
- The first group of patients will place one of their feet on a vibrating plate, which simulates the mechanical stresses and strains that our bones experience during everyday physical activities. These activities are thought to be vital in keeping bones strong and healthy.
- The second group will receive a treatment called intermittent pneumatic compression, which stimulates blood flow to bones. Blood flow to bones is known to become abnormal following a spinal cord injury.
- A third group will receive both the vibration therapy and the stimulation of blood flow.
Each of these patients will receive the treatment on one leg, allowing the other to be used as a control. Throughout these treatments, researchers will measure the patients’ bone mineral density, and monitor biochemical markers of bone turnover as well as factors connected to blood flow in bone. Bone blood flow factors will also be examined in a separate group of people with long-standing spinal cord injury and a group of matched able-bodied people.
What are the researchers' credentials?
|Project Leader||Professor M Ferguson-Pell|
|Location||Insitute of Orthopaedics and Musculoskeletal Science and Spinal Injury Unit at Royal National Orthopaedic Hospital, Stanmore|
|Grant awarded||6 July 2006|
|Start date||1 October 2006|
|End date||30 September 2009|
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Professor Ferguson-Pell is a world expert in the development of new technologies to help people with disabilities. The experienced team of academic and clinical researchers working with him on this project has been together for over five years. They have led ground-breaking research into the use of drugs to prevent bone loss after spinal cord injury, and now seek long-term treatments that avoid the use of powerful drugs.
The Royal National Orthopaedic Hospital, where the research will take place, is the jewel in the crown of advanced orthopaedics in the UK, and the facilities there are ideal for this study.
Who stands to benefit from this research and how?
Preventing fractures after paralysis
Researchers hope their studies will offer benefits to patients who’ve been paralysed after damaging their spinal cord. Around 600 people suffer these devastating injuries each year in the UK.1 They tend to be young, typically in their late teens or early twenties, in the prime of their lives.
Finding a way to keep bones strong after paralysis could help prevent fractures. Currently, paralysed patients are vulnerable to breaking a bone, for example, when falling from a wheelchair, during physiotherapy or even when simply turning in bed.
Many people live in hope that the ongoing search for ways to repair the spinal cord will give them a better chance of regaining some movement or walking again. A treatment that keeps bones strong would enable patients to benefit from future advances in spinal repair with less worry about breaking a bone.
Potential benefits for millions with osteoporosis
Researchers hope their study will also shed light on the mechanisms responsible for osteoporosis in the elderly population. The impact of these findings could therefore lead to benefits for many millions of people worldwide.
- Spinal cord injury association. Annual report 2003-2004.
- van Staa TP, Dennison EM, Leufkens HG, Cooper C. Epidemiology of fractures in England and Wales. Bone 2001; 29:517-22.
- www.statistics.gov.uk/cci/nugget.asp?id=1263. Population estimates, Office for National Statistics. Census 2001, Office for National Statistics. Census 2001, General Register Office for Scotland.
- Biering-Sorensen F, Bohr HH, Schaadt OP. Longitudinal study of bone mineral content in the lumbar spine, the forearm and the lower extremities after spinal cord injury. Eur J Clin Invest 1990; 20:330-5.