# Effects of Electrical Stimulation and Vitamin D supplementation on Bone Health Following Spinal Cord Injury.

> **NIH VA IK1** · VA VETERANS ADMINISTRATION HOSPITAL · 2024 · —

## Abstract

Project Summary/Abstract
 Neurogenic osteoporosis is a devastating problem that is likely to impact 46,000
Veterans with chronic spinal cord injury (SCI). It is typically associated with low impact fractures
of long bones and other medical comorbidities. It is estimated that approximately fifty percent of
all individuals with SCI will develop low impact fracture during their lifetime. The management of
osteoporosis related fractures can impose substantial economic burden on the health care
system, individuals with SCI and their families. Advancement in medical research clearly
indicated that neurogenic osteoporosis is linked to reduced loading and Vitamin D (Vit D)
deficiency. Our pilot work indicated that a simple rehabilitation paradigm targeting towards
evoking skeletal muscle hypertrophy may attenuate deterioration in trabecular bone parameters
after SCI. Evoked resistance training (RT) using surface neuromuscular electrical stimulation
(NMES) has been shown as a successful and feasible home-based approach to load skeletal
muscles after SCI. Our earlier results may imply long term compliance and adherence if
successfully applied in conjunction with a telehealth approach. In the present study, we propose
a simple home-based approach of using NMES RT in conjunction with oral Vit D
supplementation on trabecular bone quality in 20 Veterans with chronic SCI. Data will include
measurements of trabecular bone quality as determined by magnetic resonance imaging (MRI)
and bone biomarkers associated with the process of bone remodeling.
 Twenty participants with chronic (> 1-year post-injury) motor complete (AIS A and B) SCI
(18 to 65 years of age) will be randomly assigned into either NMES RT plus 2000IU of Vit D (10
participants) or passive movement plus 2000IU Vit D (10 participants) to participate in a
repeated measure design trial for 9 months. The NMES RT plus Vit D will undergo 4.5 months
of open kinematic chain resistance training followed by 4.5 months of closed kinematic chain
using simple rowing approach. This pilot work will have two main specific aims. Aim 1. To
determine the impact of home based NMES RT protocol plus oral Vit D supplementation
compared to passive movement plus oral Vit D on bone microarchitectural properties. Aim 2.
To determine the impact of home based NMES RT protocol plus oral Vit D compared to passive
movement and Vit D supplementation on biomarkers of bone formation and bone resorption.
Key words: Spinal cord injury, osteoporosis, bone turnover, bone remodeling, bone biomarkers,
electrical stimulation, vitamin D.

## Key facts

- **NIH application ID:** 10954245
- **Project number:** 5IK1RX003529-03
- **Recipient organization:** VA VETERANS ADMINISTRATION HOSPITAL
- **Principal Investigator:** Dora E. Ifon
- **Activity code:** IK1 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2021-10-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10954245

## Citation

> US National Institutes of Health, RePORTER application 10954245, Effects of Electrical Stimulation and Vitamin D supplementation on Bone Health Following Spinal Cord Injury. (5IK1RX003529-03). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10954245. Licensed CC0.

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