Dr. Craven's clinical and research expertise is in the prevention and treatment of secondary health conditions among people living with spinal cord injury (SCI), with a focus on sublesional osteoporosis (SLOP), the interrelationships between body composition and multimorbidity of chronic disease, and health service provision.
SLOP is a disease process unique to patients with traumatic SCI characterized by excessive bone resorption, regional declines in bone mineral density (BMD) and bone quality (architecture and strength) of the hips and knee regions, thereby increasing the propensity for lower extremity fragility fracture. One in ten people with SCI report lower extremity fractures in the last year, with a persisting five-year increase in mortality following the fracture. Fractures increase patient morbidity due to complications of fracture immobilization (i.e. heel ulcer or deep venous thrombosis) and often results in delayed union or non-union, which temporarily decreases the person's functional abilities and increases their attendant care needs.
The primary aim of my research is to reduce fracture occurrence and the fracture related morbidity and mortality among patients with SCI.
Detection and Treatment of Sublesional Osteoporosis
We have developed clinical paradigms for the detection and treatment of sublesional osteoporosis. In addition, our team has also been utilizing new imaging technology to measure regional changes in bone mineral density, bone architecture and body composition around the knee in order to identify people with SCI at high risk of fracture who require treatment.
To date, my research interests include:
- The prevention and treatment of SLOP after spinal cord injury
- Determining the efficacy of oral bisphosphonate therapy for the prevention and treatment of SLOP
- Determining the safety and efficacy of rehabilitation interventions including passive standing (PS), functional electrical stimulation (FES), body weight support treadmill training (BWSTT) and whole body vibration (WBV) for treatment of SLOP
- Determining the physiological and psychological benefits of longitudinal exercise interventions among people with SCI
- Diagnosis, measurement and clinical implications of changes in body composition over time among patients with SCI
- Economic consequences of secondary health conditions of SCI
- Development of non-invasive protocols for the identification of individuals with SCI, metabolic syndrome, and an increased risk of adverse cardiovascular events