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Prevalence of low bone mineral density in inpatients with traumatic brain injury receiving neurobehavioural rehabilitation: a postoperative, observational study

Banham-Hall, N., Kothwal, K., Pipkin, J., Bentley, J. and Dickens, G. (2013) Prevalence of low bone mineral density in inpatients with traumatic brain injury receiving neurobehavioural rehabilitation: a postoperative, observational study. Physiotherapy. 99(4), pp. 328-334. 0031-9406.

Item Type: Article
Abstract: Background Osteoporosis is characterised by low bone mineral density (BMD) leading to an increased risk of fracture. Patients who have sustained a significant traumatic brain injury may have an increased risk of secondary reduced BMD as a result of immobility and other factors. Objectives To describe BMD in a cohort of patients recovering from traumatic brain injury, and to discuss the implications of the findings for physiotherapy practice. Design Prospective, observational. Setting Specialist, residential unit providing care for individuals with brain injury, many with a history of severe challenging behaviour. Participants Current inpatients (n = 51, 80% male) with the capacity to provide consent, as judged by their responsible clinician. The median age was 41 years (range 20 to 60 years), and the median time since the brain injury was sustained was 22 years (range 4 to 54 years). Methods Participants’ BMD was measured at the radius and tibia using quantitative ultrasound. Various clinical and demographic details were collected. Results Participants had suboptimal BMD measurements that were generally low for their age and gender. Nine (18%) participants met the criteria for osteopenia measured at the radius, and 26 (51%) participants met criteria for osteoporosis or osteopenia measured at the tibia. Conclusions Some participants had reduced BMD, putting them at risk of fracture or of developing such risk in the future. This group is at particular risk because they frequently display challenging aggressive behaviours that may be met with responses including proportionate use of manual restraint. Physiotherapists should bear this increased risk in mind when devising exercise programmes assessing risk in neurobehavioural rehabilitation settings.
Uncontrolled Keywords: Osteoporosis, osteopenia, bone mineral density, quantitative ultrasound, physiotherapy, brain injury
Subjects: R Medicine > RC Internal medicine > RC387 Brain injuries
R Medicine > RM Therapeutics. Pharmacology > RM695 Physical medicine. Physical therapy
R Medicine > RC Internal medicine > RC925 Diseases of the musculoskeletal system > RC931.O73 Osteoporosis
Creators: Banham-Hall, Nicola, Kothwal, Krishna, Pipkin, Jane, Bentley, Judith and Dickens, Geoff
Publisher: Elsevier
Northamptonshire and East Midlands: Health
Faculties, Divisions and Institutes: University Faculties, Divisions and Research Centres - OLD > Faculty of Health & Society
University Faculties, Divisions and Research Centres - OLD > Research Centre > Institute of Health and Wellbeing
Research Centres > Centre for Health Sciences and Services
Date: December 2013
Date Type: Publication
Page Range: pp. 328-334
Journal or Publication Title: Physiotherapy
Volume: 99
Number: 4
Language: English
DOI: https://doi.org/10.1016/j.physio.2012.12.009
ISSN: 0031-9406
Status: Published / Disseminated
URI: http://nectar.northampton.ac.uk/id/eprint/6191

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