1. Intermittent Pneumatic
Compression May Improve Bone
Mineral Density at the Hip
Southwest Chapter 32nd Annual Meeting
American College of Sports Medicine
October 19th, 2012
Zakkoyya Lewis
Faculty Advisor: Hawley Almstedt, PhD, RD
3. • What is IPC?
• How could IPC help BMD?
?
Dahl, J, & et al J Orthop Res. (2007) 25(9):1185-1192
4. RESEARCH QUESTION
DOES AN IPC INTERVENTION INCREASE
BONE MINERAL DENSITY IN HEALTHY
ADULTS?
• 10 Participants (4 Male, 6 Female)
• Pre-Intervention Testing
• IPC Intervention
• Post-Intervention Testing
• 9 Participants (3 Male, 6 Female)
5. Table 1 Baseline Descriptive Characteristics
M=males, F=females, BMI= body mass index, MET=metabolic equivalent
6. Participants 1, 3, 4, and 6 demonstrated no change in BMD at the
nontreated hip
Figure 1: Total Hip BMD
-0.06
-0.05
-0.04
-0.03
-0.02
-0.01
0
0.01
0.02
BMD(g/cm2)
1 2 3 4 5 6 7 8 9
Participant
Treated
Non-Treated
7. Table 2 Bone Mineral Density
†p<0.05, ‡p<0.01 significant time by treatment interaction (i.e. the follow-up values are
significantly different than the baseline values in the treated vs. nontreated legs)
Wasnich, RD, & Miller, PD, J Clin Endocrinol Metab. (2000) 85:231-236
8. Our Study
Albertazzi, P, Steel, SA, & Bottazzi, M, Bone. (2005) 37(5):662-668
Challis, MJ, & et al, Aust J Physiother. (2007) 53(4): 247-252
•Found and increase
in BMD at the hip
•30 post menopausal
women
•IPC intervention: 2
hours/day, 24 weeks
No current injury
•Only 2 post menopausal
participants
•Shorter duration
•30 post menapausal
participants
•Longer duration
•Current fracture
•No history of fracture
•Mixed gender
•10 week intervention
•Found and increase in
BMD in the radius after a
radial fracture
•21 participants
•IPC intervention: 20
minutes/day, 10 weeks
Challis & et alAlbertazzi & et al
9. The results of this
preliminary
investigation suggest
that IPC may be
osteogenic and warrants
further investigation as
a means to reduce
outcomes of
osteoporosis
10. ACKNOWLEDGEMENTS
• Faculty Advisor: Hawley Almstedt, PhD, RD
• LMU Summer Undergraduate Research
Program
• Assistants: Liam Shorrock and Daniel
Echeverry
• Volunteer Research Participants
Editor's Notes
Brighter red- play with colors & font
Weight bearing picture
How many weeks we r in
Acknowledge: SURP, Liam, Daniel, & volunteer participant
Why BMD?
Brief discussion on what BMD is
Statistics on why it is important
Touch on why it is important: those who do not have an adequate BMD are susceptible to osteoporosis (definition, increased risk of fractures)
How is BMD improved?
Nutrition is important: making sure you have enough energy available from food intake to allow for bone to metabolize
Physical activity
Potentially compresion– studies show success in fracture patients
What is IPC?
Describe how it works and looks
Common uses to prevent DVT and reduce edema
How could IPC help BMD?
Thought to improve fracture healing and bone growth
Introduce the research question
Describe participants: variety of ages, 2 post menapausal, 1 breast feeding
Pre-intervention: measuring height, weight, body composition (skinfold, circumference), physical activity questionnaire, rapid assessment method questionnaire (RAM) for nutrient intake, DXA scan.
During intervention measure energy expenditure (energy burned during activity) using accelerometers and also recorded dietary intake
Intervention
About 40 sessions, 1 hour a day, typically 4-5 days a week, for 10 weeks. At office, in lab, or at home
One leg was chosen over the other because…
Two different units used- difference between them; wanted to see which one would be best in a larger study
Post-intervention
Re-evaluated height, weight, body composition, & DXA scan
Two-way, repeated measures analysis of variance (ANOVA)
Each their own control
Removal of one subject: drastic change in PA, likely to alter bone metabolism
43.4 +/-3.8 hours, 9.6 +/-0.8 weeks
Calcium 66-103%
Explain the large difference: considering it’s a preliminary study the goal was not homogeneity but rather to get a look at who would benefit most and how feasible the intervention was between groups
Highlight on the averages
Differences do not affect results since they act as their own control
4 participants, no change in nontreated
Average: treated hip increased 0.5-0.9%, while the nontreated hip displayed a 0.8-1.8% decline depending on the bone site
Note significant differences
The ANOVA indicated a significant difference in change in BMD between treated and nontreated limbs at the femoral neck (p=0.023), trochanter (p=0.027), and the total hip (p=0.008)
DXA has 1% error BMD at spine and hip; negligible considering there is a trend at all sites
Similarities/differences to Albertazzi: These results coincide with previous work by Albertazzi et al. who report an increase BMD at the femoral neck in 30 postmenopausal women after a 2-hour daily IPC intervention of 24 weeks [6]. Our investigation is similar to theirs in that our participants did not currently have a bone injury. However, their participants were all postmenopausal women with the average age of about 70, while only two of our participants were postmenopausal and were much younger
Similarities/differences to Challis: short time frame, mixed gender vs fracture
Strengths: own control, variety of participants, good compliance,
weaknesses: size and short duration
Need for future work
