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Completed

NCT Number: NCT07725081

Osteoporosis Awareness in Chronic Spinal Cord Injury

Osteoporosis is a common and serious complication of spinal cord injury (SCI), substantially increasing the risk of fragility fractures. Despite this elevated risk, awareness of osteoporosis among individuals living with SCI is not well understood. This cross-sectional observational study assessed the level of osteoporosis awareness in adults with chronic traumatic SCI and examined which demographic, injury-related, and healthcare-related factors were independently associated with awareness. Ninety-four adults with chronic traumatic SCI completed the Turkish version of the Osteoporosis Awareness Scale, along with a structured questionnaire covering education, injury characteristics, healthcare utilization, and personal health-seeking behaviors. The study aimed to identify modifiable factors linked to higher awareness in order to inform future educational interventions and improve osteoporosis prevention and management in this high-risk population.

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Key information

Conditions

Spinal Cord Injuries (SCI) Attitudes Behavior Bone Diseases Bone Diseases, Metabolic Central Nervous System Diseases Health Knowledge Metabolic Diseases Musculoskeletal Diseases Nervous System Diseases Nutritional and Metabolic Diseases Osteoporosis Patient Education as Topic Practice Spinal Cord Diseases Spinal Cord Injuries Trauma, Nervous System Wounds and Injuries

Age range

18 year–100 year

Sex eligibility

All sexes

Study type

Observational

Primary location

Afyonkarahisar Health Sciences University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Afyonkarahisar, 03030, Turkey (Türkiye)

About this study

Background: Individuals with spinal cord injury (SCI) experience rapid and severe sublesional bone loss, with fracture rates several-fold higher than in the general population. Patient awareness is an important determinant of preventive behavior, screening participation, and treatment adherence, yet the factors shaping osteoporosis awareness in the SCI population have not been systematically investigated, and no such data exist for the Turkish SCI population.

Objectives: The study aimed to (1) assess osteoporosis awareness among individuals with chronic SCI using a validated instrument; (2) examine bivariate associations between potential predictors and awareness; and (3) identify factors independently associated with awareness through multivariable regression.

Design and Setting: This was a single-center, cross-sectional observational study conducted at a tertiary physical medicine and rehabilitation center between January and December 2023.

Participants: Ninety-four adults with documented traumatic SCI of at least 12 months' duration were enrolled through consecutive sampling. Individuals with significant cognitive impairment, acute illness requiring hospitalization, or inability to complete questionnaires in Turkish were excluded. Only traumatic SCI cases were included.

Measures: Osteoporosis awareness was assessed using the Turkish version of the Osteoporosis Awareness Scale (31 items; total score range 31 to 124). Additional data included age, sex, education level, injury level and completeness, ASIA Impairment Scale grade, injury duration, fracture history, regular follow-up, receipt of osteoporosis education, personal research, bone density testing history, and use of bone-relevant medications.

Statistical Analysis: Bivariate analyses used t-tests, one-way ANOVA, and correlation coefficients, with effect sizes reported. Multiple linear regression with nine predictors identified factors independently associated with awareness. Regression diagnostics and a sensitivity analysis were performed to confirm robustness.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Documented traumatic spinal cord injury
  • Injury duration of at least 12 months (chronic SCI)
  • Age 18 years or older
  • Able to provide informed consent and complete questionnaires in Turkish

Exclusion criteria

  • Significant cognitive impairment precluding reliable questionnaire completion
  • Acute medical illness requiring hospitalization
  • Inability to communicate in Turkish
  • Non-traumatic etiology of spinal cord injury

Treatment and study plan

Primary outcomes

  1. Level of osteoporosis awareness

    Time frame: At a single time point (baseline assessment)

    Osteoporosis awareness was measured using the total score of the Turkish version of the Osteoporosis Awareness Scale (OAS), a 31-item instrument rated on a 4-point Likert scale, with total scores ranging from 31 to 124. Higher scores indicate greater osteoporosis awareness. The scale was administered once, at study enrollment.

Secondary outcomes

  1. Factors independently associated with osteoporosis awareness

    Time frame: At a single time point (baseline assessment)

    Demographic, injury-related, and healthcare-related factors independently associated with OAS total scores, assessed by multiple linear regression. Candidate factors included age, sex, education level, injury duration, ASIA Impairment Scale grade, fracture history, regular osteoporosis-related follow-up, personal research, and receipt of osteoporosis education.

  2. Osteoporosis-related healthcare utilization and health-seeking behaviors

    Time frame: At a single time point (baseline assessment)

    Proportions of participants reporting regular osteoporosis-related follow-up, prior receipt of osteoporosis education, personal research on osteoporosis, prior bone density (DXA) testing, and awareness of DXA scanning, assessed by structured questionnaire.

Sponsors and collaborators

Lead sponsor

Afyonkarahisar Health Sciences University

Other

Registry information

Official study title

Osteoporosis Awareness in Individuals With Chronic Spinal Cord Injury: Factors Associated With Education and Health-Seeking Behaviors

Important dates

Study start
2023
Primary completion
2024
Study completion
2024
First posted
Jul 24, 2026
Registry last updated
Jul 24, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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