Spasticity and bone mineral density after spinal cord injury

Abstract

Objective: To evaluate the effects of lower limb spasticity on bone mineral density (BMD) after chronic spinal cord injury.Design: Observational cross-sectional study.Setting: Department of PMR, SMS hospital, Jaipur Participants: 50 individuals of chronic motor complete SCI were classified into mild (n=16), moderate (n=11), and severe (n=23) spastic groups; based on their lower limb extensor muscle group spasticity score using a Modified Ashworth Scale (M.A.S). A DEXA scanner was used to measure bone mineral density (BMD, g/cm²) and were compared between the groups with different grades of spasticity. Results:  The mean M.A.S score in severe, mild and moderate spastic was 5.28 ± 0.54, 1.84±0.30 and 3.14±0.32 respectively (P<0.001S). Majority i.e. 46% (n=23) were osteopenic ; 16% (n=8) were osteoporotic; while 38% (n=19) had normal bone mineral density at hip joint (P=0.753NS).  The mean duration of spinal cord injury was 2.14±0.881 years (P = 0.487NS). Conclusion: A significant association was found between mean M.A.S and type of spasticity. While no significant association was observed between the severity of lower limb spasticity and bone mineral density among SCI individuals.

Keywords: Spinal cord injury, Spasticity, Modified Ashworth score