AboAbat, AM 1999, Spinal cord injury in Saudi Arabia : characteristics, bone mineral density, and functional electrical stimulation for upright mobility , PhD thesis, University of Salford.

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Abstract

Comparing reports from different countries,o ne finds considerabled iscrepanciesin the epidemiological and demographical variables of the spinal cord injury (SCI). In this thesis, a nation-wide SCI survey was conducted for the first time in Saudi Arabia it showed that the current situation and characteristic features of SCI patients was significantly different from that in other countries and there is deficiency in medical and rehabilitation services provided for the treatment of this condition. The incidence rate of SCI in Saudi Arabia exceeded all values reported from other countries. The survey showed that the incidence of fracture in long bones was also comparatively high. In spite of the high rate of fractures occurring around the knee joint in chronic SCI patients, no specific study has been carried out measure bone mineral density (BMD) values of this site. Therefore, as part of this research BMD was measured at different sites in the skeleton using Dual Energy X-ray Absorptiometry (LUNAR). This included measurement at seven regions around the knee joint in both Saudi SCI patients and ablebodied subjects using modified Lunar Software. This study demonstrated that BMD around the knee joint, particularly the femoral supracondyle, was more powerful predictor of the risk of fractures occuring in long bones of SCI individuals than measurement at the proximal femur. Utilising this data, new diagnostic criteria were developed to indentify patients at risk of those fractures. Although the survey showed that most patients did not receive appropriate rehabilitation for upright mobility, many of them expressedto wish to attempt standing and walking. Therefore, in this study, Functional Electrical Stimulation techniques were used for the first time in Saudi Arabia to restoreu pright locomotion using the ParastepOs ystem.T he ambulatory performance of subjects in this study was similar to that in other studies world-wide. There were some shortcomings observed with this system, which negatively affected walking parameters. Those shortcomings were presented and discussed in this thesis with appropriate recommendations on how they might be overcome.

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