CONTACT: JENNIFER BROWN
Iowa City IA 52242
(319) 335-9917; fax(319) 335-8034
Release: Dec. 15, 2000
UI physical therapy researcher receives $529,000 NIH grant
IOWA CITY, Iowa -- A spinal cord injury causes dramatic changes in the bones,
muscles and nervous system below the point of injury. The weight bearing bones
in the leg become osteoporotic (less dense and more brittle) and the muscles
undergo a mass transformation into "fast-twitch" muscles, which
means they fatigue easily. The nervous system, denied its normal input from
the brain, undergoes reorganization leading to spasms from overactive spinal
University of Iowa Health Care researcher Richard K. Shields, Ph.D., associate
professor in the UI Graduate Program in Physical Therapy, has received a four-year,
$529,000 grant from the National Institutes of Health to investigate ways
of preventing these damaging changes to the neuromusculoskeletal system after
spinal cord injury.
"This research emanates from the understanding that even if there were
a cure for spinal cord injury today, most individuals in wheelchairs would
not be able to take advantage of the cure," Shields said. "The substantial
changes to their bones, muscles and spinal reflexes would make them very poor
candidates to take advantage of any future advances."
In addition to being very difficult to reverse, bone and muscle degeneration
after spinal cord injury is very rapid. In the course of a year, the bones
become highly osteoporotic and the muscles have transformed. Preliminary results
from Shields' work suggest that early rehabilitation techniques after the
injury can maintain the normal properties of the muscles, bones, and spinal
The protocol developed by Shields involves electrically stimulating the
muscles and exerting load through the skeletal system, which mimics normal
weight bearing actions.
"Our protocol starts shortly after the injury, and may represent a
paradigm shift in rehabilitation," Shields said. "Instead of focusing
only on the non-paralyzed extremities, perhaps rehabilitation in the 21st
century will embark on also sustaining the muscle, bone, and reflex systems
of the paralyzed extremities as well."
"This will be an increasingly important approach as it appears that
other scientists may be moving toward possible ways to cure the damaged spinal
cord," he added.
However, even if a cure for spinal cord injuries is not developed in the
near future, Shields hopes to show that his methods to sustain the overall
health of the paralyzed extremities in these patients will improve their quality
of life today.
"For patients who develop osteoporosis after a spinal cord injury,
something as simple as putting on a shoe creates a risk of fracturing a bone.
But if bone health is maintained, the risk of these pathological fractures
is reduced," Shields said. "Also, by maintaining normal spinal reflexes
and healthy musculature, the incidence and severity of muscle spasms may be
Shields' work may also have implications for the space program. The damage
to the bones and muscles caused by spinal cord injury mimics the changes that
occur in bones and muscles due to weightlessness in space.
"The results of our work could potentially be of use in combating the
problems of osteoporosis and muscle transformation associated with long-term
space living," Shields said.
University of Iowa Health Care describes the partnership between
the UI College of Medicine and the UI Hospitals and Clinics and the patient
care, medical education and research programs and services they provide.