BONE-MINERAL STATUS IN PARAPLEGIC PATIENTS WHO DO OR DO NOT PERFORM STANDING

Bone mineral density (BMD) was assessed by dual-photon X-ray absorptio metry at the lumbar spine (L3, L4), the proximal femur and the femoral shaft, and by single-photon absorptiometry at the forearm in 53 patie nts with complete traumatic paraplegia of at least 1 year's duration a nd in age- and sex-matched healthy controls. The patients did (n = 38) or did not (n = 15) regularly perform passive weightbearing standing with the aid of a standing device. Compared with the controls, the BMD of paraplegic patients was preserved in the lumbar spine and was mark edly decreased in the proximal femur (33%) and the femoral shaft (25%) . When considering all patients performing standing, they had a better -preserved BMD at the femoral shaft (p = 0.009), but not at the proxim al femur, than patients not performing standing. BMD at the lumbar spi ne (L3,L4) was marginally higher in the standing group (significant on ly for L3; p = 0.040). A subgroup of patients performing standing with use of long leg braces had a significantly higher BMD at the proximal femur than patients using a standing frame or a standing wheelchair ( p = 0.030). The present results suggest that passive mechanical loadin g can have a beneficial effect on the preservation of bone mass in ost eoporosis found in paraplegics.