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L - Skeletal Integrity

REPORT CARD: Skeletal Integrity KNOWLEDGE GENERATION CLINICAL APPLICATION Innovaon/Discovery Integrave Care Environmental Shi Emerging Evidence Outcome Measures Resource Capacity Take Home Mesage: Priority funding should be given to support a multicentre prospective study to develop an authoritative understanding of the epidemiology of SLOP, enable identification of individuals with high fracture risk, and define the effectiveness of calcium and vitamin D supplements. Further knowledge translation efforts should focus on dissemination of a common knee region BMD test protocol. Resources Effecve Pracce (Evidence and Outcomes) Equity Pracce Capacity Change Agents Societal Awareness Community Capacity 2020 PRIORITY 3 2020 PRIORITY 1 2020 PRIORITY 2 1. Craven BC, Robertson LA, McGillivray CF, Adachi JD. Detection and treatment of sublesional osteoporosis among patients with chronic spinal cord injury: proposed paradigms. Top Spinal Cord Inj Rehabil. 2009;14(4):1-22. 2. Parsons K, Lammertse D. Epidemiology, prevention and system of care of spinal cord disorders. Arch Phys Med Rehabil. 1991;72(Suppl. 4):S293-4. 3. Morse LR, Battaglino RA, Stolzmann KL, et al. Osteoporotic fractures and hospitalization risk in chronic spinal cord injury. Osteoporos Int. 2009;20(3):385-92. 4. Garland DE, Adkins RH, Kushwaha V, Stewart C. Risk factors for osteoporosis at the knee in the spinal cord injury population. J Spinal Cord Med. 2004;27(Suppl. 3):202-6. 5. Garland DE, Adkins RH, Stewart CA. Fracture threshold and risk for osteoporosis and pathological fractures in individuals with spinal cord injury. Top Spinal Cord Inj Rehabil. 2005;11(1):61-9. 6. Slade JM, Bickel SC, Modlesky CM, Majumdar S, Dudley GA. Trabecular bone is more deteriorated in spinal cord injured versus estrogen-free postmenopausal women. Osteoporos Int. 2005;16(3):263-72. 7. Ragnarson K, Sell G. Lower extremity fractures after spinal cord injury: a retrospective study. Arch Phys Med Rehabil. 1981;62:418-23. 8. Freehafer AA. Limb fractures in patients with spinal cord injury. Arch Phys Med Rehabil. 1995;76(9):823-7. 9. Vestergaard P, Krogh K, Rejnmark L, Mosekilde L. Fracture rates and risk factors for fractures 2 POLICY CHANGE in patients with spinal cord injury. Spinal Cord. 1998;36(11):790-6. 10. Eser P, Frotzler A, Zehnder Y, Denoth J: Fracture threshold in the femur and tibia of people with spinal cord injury as determined by peripheral quantitative computed tomography. Arch Phys Med Rehabil. 2005;86(3):498-504. 11. Writing Group for the ISCD Position Development Conference. Technical standardization for dual-energy X-ray absorptiometry. J Clin Densitom. 2004;7(1):27-36. 12. Baim S, Wilson CR, Lewicki EM, Downs MR, Lentle BR. Precision assessment and radiation safety for dual-energy X-ray absorptiometry: position paper of the International Society for Clinical Densitometry. J Clin Densitom. 2005;8(4):371-8. 13. Shapiro J, Smith B, Beck T, et al. Treatment with zoledronic acid ameliorates negative geometric changes in the proximal femur following acute spinal cord injury. Calcif Tissue Int. 2007;80:316-22. 14. Bubbear JS, Gall A, Middleton FR, Ferguson Pell M, Swaminathan R, Keen RW. Early treatment with zoledronic acid prevents bone loss at the hip following acute spinal cord injury. Osteoporos Int. 2011;22(1):271-9. 15. Zehnder Y, Risi S, Michel D, et al. Prevention of bone loss in paraplegics over 2 years with alendronate. J Bone Miner Res. 2004;19(7):1067-74. 16. Biering-Sorensen F, Hansen B, Lee BS. Non-pharmacological treatment and prevention of bone loss after spinal cord injury: a systematic review. Spinal Cord. 2009;47(7):508–18. 126 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


L - Skeletal Integrity
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