Preserving and maintaining bone mass after a spinal cord injury (SCI) is crucial to decrease the risk of fragility or low trauma fractures — significant health events that occur as a result of minimal trauma such as falling during transfers or from a standing height or less. There is an increased risk for low trauma fractures after an SCI especially in the lower extremity. Therefore, the purpose of this systematic review was to appraise the literature to provide clinical guidance for the optimization of bone health after SCI. The key research questions focused on prevention of acute bone loss after SCI (<1 year) and effective treatment of established low bone mass with long-standing SCI (⩾ 1 year). We report moderate evidence for the treatment of bone loss using pharmacology; however, nonpharmacological evidence for preventing and treating bone loss is limited.

functional electrical stimulation, osteoporosis, pharmacology, rehabilitation, spinal cord injury
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