{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T19:44:11Z","timestamp":1786995851348,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T00:00:00Z","timestamp":1364774400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100004312","name":"Eli Lilly and Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004312","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002429","name":"Amgen","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100002429","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the response of bone to 2 anabolic stimuli, teriparatide and mechanical loading, in subjects with spinal cord injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A pilot study, 1 group, pretest\u2010posttest.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A rehabilitation hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A convenience sample of 12 nonambulatory chronic spinal cord injury subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The subjects were administered open\u2010label teriparatide 20 \u03bcg\/d while undergoing robotic\u2010assisted stepping 3 times a week for 6 months, followed by 6 months of teriparatide alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measurements<\/jats:title>\n                    <jats:p>Bone status was evaluated at 3, 6, and 12 months by using dual\u2010energy x\u2010ray absorptiometry to calculate bone mineral density (BMD) at the spine and hip, magnetic resonance imaging to assess bone microarchitecture of the distal tibia, and serum bone markers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean (SD) baseline BMD measurements at the spine and the left and right total hip were 1.05 \u00b1 0.162 g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      , 0.638 \u00b1 0.090 g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      and 0.626 \u00b1 0.088 g\/cm\n                      <jats:sup>2<\/jats:sup>\n                      , respectively. After 6 months of treatment, BMD changed 2.19% \u00b1 3.61%, 0.02% \u00b1 2.21%, and 0.74% \u00b1 2.80% at the spine, and left and right total hip, respectively. These changes were not statistically significant (\n                      <jats:italic>P<\/jats:italic>\n                      &gt; .05 for all). Magnetic resonance imaging supported an anabolic effect after 3 months of treatment with significant (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05) changes in trabecular thickness, 4.4% \u00b1 4.06%; surface\u2010to\u2010curve ratio, 23.6% \u00b1 22.3%; and erosion index, \u221217.04% \u00b1 12.9%. Although the trend remained after 6 months, statistical significance was not retained. At 6 months, bone markers indicated an increase in mean levels of bone\u2010specific alkaline phosphatase, 53.8% \u00b1 62.9%; C\u2010terminal telopeptides of type I collagen, 137.6% \u00b1 194.6%; and intact amino\u2010terminal propeptide of type I procollagen, 61.4% \u00b1 99.3%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this limited pilot study, teriparatide and mechanical loading resulted in a numerical but not statistically significant increase in lumbar spine BMD and no significant BMD changes at the hip. Magnetic resonance imaging at the distal tibia suggested an anabolic effect, but the high sensitivity offered by this technique was challenged by the limited ability to obtain analyzable data from all the subjects. Further studies that involve longer treatment periods and greater mechanical loading are warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.pmrj.2013.03.032","type":"journal-article","created":{"date-parts":[[2013,4,1]],"date-time":"2013-04-01T11:30:20Z","timestamp":1364815820000},"page":"663-671","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":52,"title":["Effect of Parathyroid Hormone Combined With Gait Training on Bone Density and Bone Architecture in People With Chronic Spinal Cord Injury"],"prefix":"10.1002","volume":"5","author":[{"given":"Keith E.","family":"Gordon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Wald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Schnitzer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,4]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2265.2006.02683.x"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101832"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3100905"},{"key":"e_1_2_7_5_2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1310\/T4XT-7DHM-K982-QM2T","article-title":"The natural history of bone loss in the lower extremity of complete spinal cord\u2010injured males","volume":"11","author":"Garland D.E.","year":"2005","journal-title":"Top Spinal Cord Inj Rehabil"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-003-1529-6"},{"key":"e_1_2_7_7_2","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1038\/sj.sc.3101685","article-title":"Long\u2010term changes in the tibia and radius bone mineral density following spinal cord injury","volume":"43","author":"Bruin E.D.","year":"2005","journal-title":"Spinal Cord"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9610(62)90256-8"},{"key":"e_1_2_7_9_2","first-page":"418","article-title":"Lower extremity fractures after spinal cord injury: A retrospective study","volume":"62","author":"Ragnarsson K.T.","year":"1981","journal-title":"Arch Phys Med Rehabil"},{"key":"e_1_2_7_10_2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1310\/G6TD-HPGC-XM3Q-7YJH","article-title":"Fracture threshold and risk for osteoporosis and pathologic fractures in individuals with spinal cord injury","volume":"11","author":"Garland D.E.","year":"2005","journal-title":"Top Spinal Cord Inj Rehabil"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00223-006-0045-z"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2005.08.017"},{"key":"e_1_2_7_13_2","first-page":"593","article-title":"Aerobic exercise as a countermeasure for microgravity\u2010induced bone loss and muscle atrophy in a rat hindlimb suspension model","volume":"71","author":"Norman T.L.","year":"2000","journal-title":"Aviat Space Environ Med"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1310\/sci1301-123"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s007740170027"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1210\/endo.139.10.6227"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2003.18.12.2116"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.1999.14.3.439"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01622.2005"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2006.09.008"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-2013"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.040313"},{"key":"e_1_2_7_23_2","doi-asserted-by":"publisher","DOI":"10.1002\/mrm.21905"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2005.859192"},{"key":"e_1_2_7_25_2","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.2001.16.8.1520"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1109\/TMI.2003.819925"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101139"},{"key":"e_1_2_7_28_2","first-page":"141","article-title":"Traumatic lower limb fractures following complete spinal cord injury","volume":"98","author":"Mulsow J.","year":"2005","journal-title":"Ir Med J"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00198-008-0671-6"},{"key":"e_1_2_7_30_2","first-page":"197","article-title":"Bone loss and steady state after spinal cord injury: A cross\u2010sectional study using pQCT","volume":"4","author":"Eser P.","year":"2004","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0b013e32831a46d6"},{"key":"e_1_2_7_32_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200105103441904"},{"key":"e_1_2_7_33_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200565170-00005"},{"key":"e_1_2_7_34_2","first-page":"45","article-title":"The impact of skeletal unloading on bone formation","volume":"16","author":"Bikle D.D.","year":"2003","journal-title":"Gravit Space Biol Bull"},{"key":"e_1_2_7_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2008.11.014"},{"key":"e_1_2_7_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1672-0229(08)60016-9"},{"key":"e_1_2_7_37_2","doi-asserted-by":"publisher","DOI":"10.2165\/00007256-200232070-00005"},{"key":"e_1_2_7_38_2","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2005.02.0036"},{"key":"e_1_2_7_39_2","doi-asserted-by":"publisher","DOI":"10.1210\/en.2002-220821"},{"key":"e_1_2_7_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2008.04.012"},{"key":"e_1_2_7_41_2","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.040808"},{"key":"e_1_2_7_42_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.1997.77.2.797"},{"key":"e_1_2_7_43_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.90949.2008"},{"key":"e_1_2_7_44_2","doi-asserted-by":"publisher","DOI":"10.1139\/h05-036"},{"key":"e_1_2_7_45_2","first-page":"288","article-title":"Muscle and bone adaptations after treadmill training in incomplete spinal cord injury: A case study using peripheral quantitative computed tomography","volume":"9","author":"Coupaud S.","year":"2009","journal-title":"J Musculoskelet Neuronal Interact"},{"key":"e_1_2_7_46_2","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1007\/s00198-011-1879-4","article-title":"High dose compressive loads attenuate bone mineral loss in humans with spinal cord injury","volume":"23","author":"Dudley\u2010Javoroski S.","year":"2011","journal-title":"Osteoporos Int"},{"key":"e_1_2_7_47_2","doi-asserted-by":"publisher","DOI":"10.1002\/jbmr.402"},{"key":"e_1_2_7_48_2","doi-asserted-by":"publisher","DOI":"10.1118\/1.3005598"},{"key":"e_1_2_7_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bone.2004.02.017"},{"key":"e_1_2_7_50_2","doi-asserted-by":"publisher","DOI":"10.1002\/jmri.22158"},{"key":"e_1_2_7_51_2","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2332"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1016%2Fj.pmrj.2013.03.032","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148213001615?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1934148213001615?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.pmrj.2013.03.032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,14]],"date-time":"2023-09-14T18:52:54Z","timestamp":1694717574000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1016\/j.pmrj.2013.03.032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,4]]},"references-count":50,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2013,8]]}},"alternative-id":["10.1016\/j.pmrj.2013.03.032"],"URL":"https:\/\/doi.org\/10.1016\/j.pmrj.2013.03.032","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"value":"1934-1482","type":"print"},{"value":"1934-1563","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,4]]},"assertion":[{"value":"2012-07-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-03-23","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-04-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}