Journal article
Vitamin D Supplementation Adjunct to Home-Based Electrical Stimulation Exercise Program Versus Passive Movement Training in Chronic SCI: Individual Results From Trial Under Accrual
Topics in spinal cord injury rehabilitation, Vol.31(4), pp.74-100
Autumn 2025
DOI: 10.46292/sci24-00051
PMCID: PMC12629214
PMID: 41268128
Abstract
Background:
Neurogenic osteoporosis as a result of bone demineralization is a well-known complication after spinal cord injury (SCI). Bone demineralization is a result of the inevitable mechanical unloading of paralyzed limbs and decreased skeletal muscle activity.
Objectives:
To determine the impact of a home-based electrical stimulation (ES)–induced exercise (Excs) protocol plus 2000 IU oral daily vitamin D (vit D) supplementation compared to passive movement training (PMT) plus 2000 IU oral daily vit D supplementation on bone microarchitectural properties as measured by magnetic resonance imaging (MRI), bone mineral density (BMD) as measured by dual-energy x-ray absorptiometry (DXA), and biomarkers of bone formation and bone resorption in persons with chronic SCI.
Methods:
Six men with motor complete SCI ranging from C8 to T10 were randomized into either 9 months of vit D+ES-Excs or vit D+PMT groups. The vit D+ES-Excs group underwent daily supplementation of vit D with 4.5 months of neuromuscular electrical stimulation-resistance training (NMESRT) followed by 4.5 months of functional electrical stimulation (FES) rowing, twice weekly, using a home-based training approach. MRI, DXA, and blood biomarkers were captured at the beginning of the study (baseline), 4.5 months (postintervention 1), and 9 months after training (post-intervention 2).
Results:
The percentage changes indicated that 2 persons in the vit D+ES-Excs group showed decreases in trabecular spacing (28%) and increases in trabecular network (33%-49% at post-intervention 2). This was accompanied by attenuation of BMD loss at the pelvis (3.6%-7.7%), femoral necks (4.5%-8.4%), and knees (10.5%-18.7%). The vit D+ES-Excs group showed increases in leg (5.3%) to total body lean mass and decreases in biomarkers of bone resorption (7.0%-23.5%). Similar changes were not demonstrated following 9 months of vit D+PMT.
Conclusion:
Home-based training with 9 months of vit D+ES exercise demonstrated the safety and practicability in mitigating deleterious changes in bone health in persons with chronic SCI. This is concomitant with increased leg lean mass and decreased circulating biomarkers of bone resorption in persons with SCI.
Details
- Title: Subtitle
- Vitamin D Supplementation Adjunct to Home-Based Electrical Stimulation Exercise Program Versus Passive Movement Training in Chronic SCI: Individual Results From Trial Under Accrual
- Creators
- Dora E. Ifon - VA Central California Health Care SystemRefka Khalil - VA Central California Health Care SystemTeodoro A. Castillo - VA Central California Health Care SystemTimothy Lavis - VA Central California Health Care SystemXiaoliu Zhang - Des Moines UniversityPunam K. Saha - University of IowaGregory Chang - NYU Langone HealthRehan M. Khan - VA Central California Health Care SystemRobert A. Adler - VA Central California Health Care SystemAshraf S. Gorgey - VA Central California Health Care System
- Resource Type
- Journal article
- Publication Details
- Topics in spinal cord injury rehabilitation, Vol.31(4), pp.74-100
- DOI
- 10.46292/sci24-00051
- PMID
- 41268128
- PMCID
- PMC12629214
- NLM abbreviation
- Top Spinal Cord Inj Rehabil
- ISSN
- 1082-0744
- eISSN
- 1945-5763
- Publisher
- AMER SPINAL INJURY ASSOC; RICHMOND
- Grant note
- VA-CDA-1 mechanism: 1 IK1 RX003529-01A2
We would like to thank all the subjects who participated in the current clinical research trial. We would like to thank the Central Virginia VA Hospital for providing the necessary space to conduct the clinical trial. The current study is funded through VA-CDA-1 mechanism (1 IK1 RX003529-01A2) to Dora Ifon, PhD. We would like to thank Milissa Janisko, RD, SCI registered dietitian, for her help and support to the current project. The research team would also like to acknowledge the help and support of Drs. Audrey Kusiak and Shirley Groer throughout the entire process of the grant cycle.
- Language
- English
- Electronic publication date
- 08/01/2025
- Date published season
- Autumn 2025
- Date published
- 2025
- Academic Unit
- Electrical and Computer Engineering
- Record Identifier
- 9984945086602771
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