17 replies to this topic

[BoyFallDown]

I haven't been in a standing frame since rehab about a year ago. I'm very worried about bone loss, but I can't afford a standing frame. Do you guys stand regularly? Does anyone know how fast bone loss occurs?

[Beautiful]

I never stand. I know I'm osteopenic though. Some people have very severe bone loss, others don't. It varies between how long you've been injured as well. Everyone is different.

Edit: Some experts say that a standing frame doesn't even help bone density.

Edited by Beautiful, 14 January 2012 - 06:31 AM.

[A trophy guy]

 BoyFallDown, on 14 January 2012 - 06:11 AM, said:

I haven't been in a standing frame since rehab about a year ago. I'm very worried about bone loss, but I can't afford a standing frame. Do you guys stand regularly? Does anyone know how fast bone loss occurs?

Hate to break to ya bud (oooh, no pun intended) but a standing frame doesn't prevent bone loss. That is going to happen, regardless of whether you passively stand in a standing chair or you don't. It takes more than simply standing to strengthen bones, it takes living on two legs. While there are benefits to using a standing frame (I won't go into them here, they have been discussed myriad times before), improving bone density is unfortunately not one of them. So don't needlessly stress yourself out about the standing chair.

[BoyFallDown]

 Beautiful, on 14 January 2012 - 06:28 AM, said:

I never stand. I know I'm osteopenic though. Some people have very severe bone loss, others don't. It varies between how long you've been injured as well. Everyone is different.

Edit: Some experts say that a standing frame doesn't even help bone density.

 A trophy guy, on 14 January 2012 - 06:31 AM, said:

 BoyFallDown, on 14 January 2012 - 06:11 AM, said:

I haven't been in a standing frame since rehab about a year ago. I'm very worried about bone loss, but I can't afford a standing frame. Do you guys stand regularly? Does anyone know how fast bone loss occurs?

Hate to break to ya bud (oooh, no pun intended) but a standing frame doesn't prevent bone loss. That is going to happen, regardless of whether you passively stand in a standing chair or you don't. It takes more than simply standing to strengthen bones, it takes living on two legs. While there are benefits to using a standing frame (I won't go into them here, they have been discussed myriad times before), improving bone density is unfortunately not one of them. So don't needlessly stress yourself out about the standing chair.

Well, that sucks. All the rehab nurses told me it was essential. Is it worth it to take a multivitamin that is high in calcium? Thanks for the info

Also, sorry to go off topic but how do you stay in such great shape trophy guy? I used to powerlift and do spinclass before my accident, now I'm not sure how to keep my weight under control.

Edited by BoyFallDown, 14 January 2012 - 06:50 AM.

[A trophy guy]

 BoyFallDown, on 14 January 2012 - 06:47 AM, said:

 Beautiful, on 14 January 2012 - 06:28 AM, said:

I never stand. I know I'm osteopenic though. Some people have very severe bone loss, others don't. It varies between how long you've been injured as well. Everyone is different.

Edit: Some experts say that a standing frame doesn't even help bone density.

 A trophy guy, on 14 January 2012 - 06:31 AM, said:

 BoyFallDown, on 14 January 2012 - 06:11 AM, said:

I haven't been in a standing frame since rehab about a year ago. I'm very worried about bone loss, but I can't afford a standing frame. Do you guys stand regularly? Does anyone know how fast bone loss occurs?

Hate to break to ya bud (oooh, no pun intended) but a standing frame doesn't prevent bone loss. That is going to happen, regardless of whether you passively stand in a standing chair or you don't. It takes more than simply standing to strengthen bones, it takes living on two legs. While there are benefits to using a standing frame (I won't go into them here, they have been discussed myriad times before), improving bone density is unfortunately not one of them. So don't needlessly stress yourself out about the standing chair.

Well, that sucks. All the rehab nurses told me it was essential. Is it worth it to take a multivitamin that is high in calcium? Thanks for the info

Also, sorry to go off topic but how do you stay in such great shape trophy guy? I used to powerlift and do spinclass before my accident, now I'm not sure how to keep my weight under control.

The research that has found the ineffectiveness of static, or passive, standing on the improvement (or stability) of bone density is relatively new; so perhaps the nurses simply weren't aware of this information. I used a standing chair myself for about 4 years before I found this out. As far as the calcium supplement, yes, that is a very good idea. That and a Vitamin D supplement (although there is doubt as to how well supplemental forms of these vitamins and minerals are absorbed). Also, of course, eat lots of calcium and vitamin-D rich foods (this is the best way for your body to get the nutrients).

Thank you for the compliment about my shape. As far as "how I do it", it's too much to try to explain each and every thing that I do and eat; it's more of a lifestyle that I've adopted and honed over the years. I talk about it (more than some would probably care to hear, I'm sure) in many threads there, so if you ever have a specific question feel free to ask.

*ETA: The picture of me in my profile is a competition photo, so I am in pre-contest shape and all tanned up. I don't look like that everyday.

Edited by A trophy guy, 14 January 2012 - 07:22 AM.

[russ1]

As for calcium supplements I was told that the body won't absorb the calcium unless it thinks it needs it - in fact the body will excrete calcium from the reducing bones and this can cause bladder stones. Thus unless your diet is low in calcium taking a calcium supplement will have no effect whatsoever and there is a possibility that it can increase the risk of bladder stones. (This advice is not applicable to menopausal women who should take calcium supplements apparently).

FES exercise is the only way I know of reducing significantly bone loss / reduced bone density

Edited by russ1, 14 January 2012 - 08:28 AM.

[Bethann]

I have a hand me down homemade wooden standing box. I need someone to help me when I get up and down but I use it quit often. It looks like a preacher's pulpit when I'm standing in it. A door closes behind my butt that keeps me standing up.

Maybe you could have one made. I don't think it'd be to hard for someone that knows woodworking.

Edited by Bethann, 14 January 2012 - 02:42 PM.

[brockit79]

I second all that A Trophy Guy has said re prevention of the depletion of bone density and standing. The exact scientific nomenclature escapes me but you need to add force to an activity/exercise an e.g of this is going up and down steps in the chair. I am hoping to take part in research of a FES rowing machine and the hypothesis , as well as improvements to the cardio-respiratory system, is that bone density is improved because of the push from the legs exerting force.

If FES is a no go then possibly try the steps thing as force will be exerted going up the step if you give it some welly? I will ask my source where the article is and add to the post if it helps.

Standing is good for stretching muscles and internal organs so that bowel and bladder can get the stretch which is essential to maintain optimal health and I do it daily but my standing frame came as part of my post hospital discharge package. I now have a standing wheelchair to enable me to use my regular kitchen which is not adapted so I get to stand doing day to day chores and is IMO worth the investment.

Broc

http://sportsmedicin...iseandBones.htm high impact exercise increases bone density - up and down steps, is something a fitness instructor told me, or weightlifting, as per this internet article, are things that may help folks restricted to chairs but who have the ability to do so.

Edited by brockit79, 15 January 2012 - 09:47 AM.

[Apparelyzed]

In addition to the above, here is a bit of interesting information I found regarding Bone Mineral Density (BMD) loss.

-----
The effect of remobilization on spinal cord injury–induced osteoporosis has been fairly well studied. Weight-bearing exercises with standing frames and bikes, using forms of functional electrical stimulation (FES), have been shown to be effective when started within 6 weeks of injury. However, these same programs in the population with chronic spinal cord injury are ineffective in preventing osteoporosis or restoring bone mineral. (FES-induced lower extremity cycling has not been shown to increase bone density in the hip parameters of patients with chronic injury.)

Changes occur rapidly in the skeleton of a patient with spinal cord injury (SCI), and interventions must be undertaken quickly. The fact that there are no effective treatments to restore bone mineral once it has been lost makes early treatment even more imperative. Thus, early prevention is the main focus in treating spinal cord injury–induced osteoporosis.

Spinal cord injury causes immediate and, in some regions, permanent gravitational unloading. The result is a disuse structural change with associated metabolic consequences. Hypercalciuria is seen by 10 days following the spinal cord injury and reaches a peak 1-6 months postinjury. This level of hypercalciuria is 2-4 times that of persons without spinal cord injury who undergo prolonged bed rest.

Rapid loss of bone mineral occurs during the first 4 months following spinal cord injury. In patients with spinal cord injury, less than 1 year following the injury, reduction in bone mineral densities (BMDs) has been noted in the femoral neck (27%), midshaft (25%), and distal femur (43%), as compared with controls.

By 10 years postinjury, over 50% of bone content in these regions has been demineralized. The arms and trunk demonstrate an increase in bone content after the 4-month point. This gain in mineral content over the next 10-year period helps to offset some of the initial losses in the arms. The net effect is an approximate 10-21% loss of bone at the 10-year point. Interestingly, the trunk has a net gain in mineral content by 12 years postinjury.

Paraplegia vs tetraplegia

Significant differences in upper extremity bone density are observed between paraplegic patients and tetraplegic patients. The BMD of the arms of paraplegic patients returns to near normal by the 10-year postinjury point, which is approximately 16% more bone mineral than is found in the arms of tetraplegic patients.

Complete vs incomplete SCI

Individuals with complete injuries tend to have less BMD than those with incomplete lesions. With complete lesions, significantly lower lumbar spine BMDs have been noted (z value -1.47) in patients 1-26 years postinjury. In addition, individuals with incomplete motor spinal cord injury demonstrate greater BMD at the areas of greater lower extremity muscle strength.

Spasticity vs flaccidity

Some controversy exists surrounding the protective effect of spasticity on bone mineral content. Studies have found a decrease in losses of bone density in patients exhibiting spasticity, compared with the flaccid group.

Source: http://emedicine.med...204-overview#a1

[Stand]

Thank you for the above information! Definitely different information that I was given or led to believe. Very interesting.

[Trinity]

 russ1, on 14 January 2012 - 08:27 AM, said:

As for calcium supplements I was told that the body won't absorb the calcium unless it thinks it needs it - in fact the body will excrete calcium from the reducing bones and this can cause bladder stones. Thus unless your diet is low in calcium taking a calcium supplement will have no effect whatsoever and there is a possibility that it can increase the risk of bladder stones.

I just wanted to re-iterate what Russ said, calcium supplements can increase your risk of bladder and/or kidney stones and this can cause a whole range or problems

a "normal" diet should have enough calcium to meet your bodies requirements. If you don't eat dairy then you may have some problems but you should really discuss any calcium supplementation with your sci dr to be on the safe side

[edlee]

Thank you for the cautions about calcium. I have been warned off of it, too,, buy my doctor. He did, however,, stress to me that Vitamin D deficiency seems to be higher in SCIs than in the general population,, and asked me to take a 400mg suppliment each day. I wonder if their is an actual study on this,, or if it simply something he has noticed in his practice.

Since, I think I read somewhere, the body produces this vitamin in the presence of sunlight,, the fact that many of us don't get out into it enough,, might have some bearing. I could be wrong about this,,, but if I google it now,, I'd have to retype all this.
ed

Well,, I went to Wiki,, and I'm okay with the sunshine thing,,, but the amount to take was wrong,, by a lot, apparrantly. I checked my pill bottle,, and it's in IUs,, not mg s,, quite a difference.

As usual,, be a bit wary of what you read here,,, some of us ( me) are idiots.
ed

Edited by edlee, 14 January 2012 - 11:14 PM.

[Millard]

Standing regularly does not prevent bone density loss. I walked for 37 years with forearm crutches. I didn't even own a chair and I walked every where I went. Around 2002, my orthopaedic surgeon started me injecting Forteo to build bone density, and it worked. After falling and breaking my kneecap in 2004, I was ordered to a (power) chair by my OS. I still do not stand but wish I had started using the chair years ago.

Good luck.

[brockit79]

http://sportsmedicin...iseandBones.htm high impact exercise increases bone density - up and down steps, is something a fitness instructor told me, or weightlifting, as per this internet article, are things that may help folks restricted to chairs but who have the ability to do so.

Edited by brockit79, 15 January 2012 - 09:48 AM.

[physiotherapist]

Hi there everyone,

From a professional point of view I just wanted to say that those of you who say that standing doesn't reduce bone loss are quite correct. The more research that has been done into this the more it has been shown that it is the vibration associated with exercise that assists with maintaining bone mineral density and therefore a static stand in a frame will not offer this. This is partly why things such as the vibro-gyms have been developed and now research is slowly getting underway to look at their accessibility for those with SCI.

However, standing does have other positive effects:

The weight-bearing through the long bones provides the best possible stretch for the lower limb muscles, partly because you have your body weight behind the stretch but also, due to the nature of the activity (i.e. standing for a prolonged period of time), the stretch is maintained for much longer. This can have a very good effect on lower limb and trunk spasms and many patients of mine have reported a lasting effect from hours to 2 or 3 days.

Getting out of a seated position regularly will also help with pressure relief and prevention of contractures - it's very good to vary your position as much as possible to ward off any adaptive muscle length changes that may ultimately impact on your functioning.

The effect of gravity can also help with things like bladder and bowel function and, finally, research has suggested that many people have a psychological benefit from standing.

If you have not stood for a long time it would be advisable to re-start under the supervision of an experienced physiotherapist though. They will need to check the alignment in your lower limbs and monitor your blood pressure response to ensure that you do it safely.

Hope this helps folks!

www.sci-services.co.uk

[Vanessamaee]

I'm not sure where exactly you guys heard/saw that fes helps with bone density. But I was told when I started that it didnt. It helps with blood flow and muscle tone and is also a cardio workout, but since it has no weight bearing and the machine is doing the work, not you, that it didnt help with bone density. I rode an fes bike twice a week for an hour at a time, going around 10.5 miles each time. I have actually stoped riding due to the facet that yes, it really does create muscle tone, since you are working out your legs muscles, they get stronger, which made spasms stronger. And for those of you that remember reading some of my posts about spasms they got to the point were I was almost completely immobilized by them. I was taking 20mg of Zanaflex a day, then made the decision to stop riding, which was a tough choice. However now I am on no medications and have no spasms, which made my life much easier. I was told by standing it helps with Bowel and Bladder and streching, I dont stand though because my blood pressure is low as it is, and if I go into a standing frame it usually drops to about 60/40 within 30seconds.

Drink your Ovaltine (:

[greybeard]

Well look who's back. Hi Vanessa. Good to hear from someone with FES experience.

[brockit79]

 Vanessamaee, on 15 January 2012 - 05:28 PM, said:

I'm not sure where exactly you guys heard/saw that fes helps with bone density. But I was told when I started that it didnt. It helps with blood flow and muscle tone and is also a cardio workout, but since it has no weight bearing and the machine is doing the work, not you, that it didnt help with bone density. I rode an fes bike twice a week for an hour at a time, going around 10.5 miles each time. I have actually stoped riding due to the facet that yes, it really does create muscle tone, since you are working out your legs muscles, they get stronger, which made spasms stronger. And for those of you that remember reading some of my posts about spasms they got to the point were I was almost completely immobilized by them. I was taking 20mg of Zanaflex a day, then made the decision to stop riding, which was a tough choice. However now I am on no medications and have no spasms, which made my life much easier. I was told by standing it helps with Bowel and Bladder and streching, I dont stand though because my blood pressure is low as it is, and if I go into a standing frame it usually drops to about 60/40 within 30seconds.

Drink your Ovaltine (:

Hi Ness

Welcome back!

It is hypothesised that the FES rower, note I say rower and not bike (very important to note), helps with bone density as it is the type of exercise and not the electrical stimulation that helps with bone density. At this stage no promises will be made until all the fabulous positive things from rowing are proven. sorry, I get very excited and forget that this machine has not yet completed the rigorous testing essential for such boastings just yet. All in good time though I'm sure of it! Go team FES ROWING WOOOO.

until then I'm on the Ovaltine! I love the stuff

Broc

Edited by brockit79, 15 January 2012 - 07:41 PM.