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Critical Reviews™ in Physical and Rehabilitation Medicine

Erscheint 4 Ausgaben pro Jahr

ISSN Druckformat: 0896-2960

ISSN Online: 2162-6553

SJR: 0.141 SNIP: 0.129 CiteScore™:: 0.6 H-Index: 18

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Sublesional Osteoporosis Prevention, Detection, and Treatment: A Decision Guide for Rehabilitation Clinicians Treating Patients with Spinal Cord Injury

Volumen 20, Ausgabe 4, 2008, pp. 277-321
DOI: 10.1615/CritRevPhysRehabilMed.v20.i4.10
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ABSTRAKT

Background. Sublesional osteoporosis (SLOP) is characterized by excessive bone resorption at the hip and knee region after spinal cord injury (SCI), resulting in a lifetime increased risk of lower extremity fracture. There are no consensus guidelines to aid clinicians in the prevention or treatment of SLOP. Objectives. (1) To review risk factors, skeletal distribution, pathophysiology, and diagnosis of SLOP; (2) familiarize clinicians with the tools available to inform clinical decisions regarding the prevention and treatment of SLOP; and (3) synthesize results of relevant SLOP systematic reviews. Methods. We conducted a literature review by searching the MEDLINE/PubMed, CINAHL®, EMBASE, and PsycINFO databases for “SCI” and 14 other bone-related MeSH terms, including publications current to July 1, 2009. The incorporated articles were graded for rigor by using the 11-item Physiotherapy Evidence Database (PEDro) for randomized control trials and the 27-item Downs and Black tool for other intervention studies with scoring modifications. Implications. Rehabilitation clinicians can use tools to identify those acute and chronic SCI patients who will benefit from prevention or treatment of low bone mineral density in the hip or knee region, respectively. Therapy selection for SCI patients should stem from the best-available evidence, an understanding of literature limitations, and knowledge of the concurrent conditions that may influence the safety and efficacy of the intervention.

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