Background
Quantification of body composition variables is important for planning of better activities in relation to individuals with spinal cord injury (SCI).Objectives
(1) To evaluate changes in body composition in patients with SCI after a supervised physical activity process; (2) To correlate total body fat with time since injury.Design
Pre-post intervention.Setting
Sarah Rehabilitation Hospital Network, Brazil.Participants
Fifty-three men with SCI aged 18–52 years with duration of injury >3 years.Interventions
The subjects were divided into three groups: tetraplegia (TT) (C5–C8), high paraplegia (HP) (T1–T6), and low paraplegia (LP) (T7–L2). Body composition was estimated in the first and last weeks of hospitalization.Outcome measures
Body weight (kg), skinfolds sum (mm), absolute (kg), and relative (%) fat and lean body mass.Results
Body weight increased in TT and decreased in HP (0.8 kg, 95%CI 0.1–1.5; and −1.0 kg, 95%CI −2.0 to 0.0, respectively; P < 0.05). Skinfolds sum decreased only in HP (−13.1 mm, 95%CI −20.7 to −5.5; P < 0.05). Absolute and relative body fat decreased significantly in the paraplegia groups. Lean body mass (LBM) percentage increased significantly in the paraplegia groups. Absolute LBM increased in TT and LP (0.8 kg, 95%CI 0.3–1.3; and 1.3 kg, 95%CI 0.8 to 1.8, respectively; P < 0.05). There was no correlation between time since injury and skinfolds sum for the three groups (P < 0.05).Conclusion
TT, HP, and LP demonstrated favorable changes in body composition after 29 days of supervised physical activity. However, these changes were different in direction and magnitude. 相似文献Context
The Thoracolumbar Injury Classification System (TLICS) has been recently described to help surgeons in the decision-making process of thoracolumbar spinal trauma.Objective
To analyze the potential relationships between the TLICS scores with the Arbeitsgemeinschaft für Osteosynthesefragen (AO) Spine System and patient''s neurological status.Methods
Literature analysis of the potential scored injuries in the TLICS system, based on its individual scores, its total score, and its suggested proposed treatment, correlating these with the AO system and neurological status.Results
Findings are presented according to the TLICS score. Patients with a TLICS 1–3 points, receiving conservative treatment, are AO type A injuries, generally neurologically intact. TLICS 4 group also included AO type A fractures, neurologically ranging from intact to complete spinal cord injury. TLICS 5–10 points includes AO type B and C injuries, regarding their neurological status, and burst fractures (AO type A) with concomitant neurological injury and most of the patients with incomplete deficits and cauda equina syndrome.Conclusions
As a general overview, according to the TLICS, patients without neurological deficit and with AO type A injuries are conservatively treated. AO type B and C injuries are managed surgically, with regard to neurological status. Patients with cauda equina or incomplete injuries also received a higher severity score. Controversies still exist regarding the management of unstable burst fractures without neurological status. The role of the posterior ligamentous complex status and the magnetic resonance imaging in the decision-making process require more clinical evidence. 相似文献Study design
Single-subject case (male, 33 years of age, T6 SCI AIS A).Objectives
To determine the effect of surface neuromuscular electrical stimulation (NMES) training conducted once weekly on improving fatigue resistance as well as regional and whole body composition in an individual with spinal cord injury (SCI).Setting
Laboratory setting within a SCI Center.Methods
Surface NMES resistance training (RT) of the paralyzed knee extensors was conducted once weekly for 12 weeks using ankle weights. Knee extensor fatigue index was determined by the number of repetitions (reps) achieved out of 30 reps. Total and regional body composition including percentage body fat (%BF), fat mass (FM), lean mass (LM) were conducted before the first session and one week after the last training session using whole-body dual-energy X-ray absorptiometry.Results
The participant had a compliance rate of 83% and he was able to lift 6 and 2 lbs on the right and left legs, respectively. Right knee extensors showed greater fatigue resistance compared to the left one. Leg LM increased by 6% accompanied with decrease in arm, trunk and total body LM by −4.7%, −13%, −5%, respectively. The %BF increased by 8%, 7.3%, 15.5%, 11.5% for arm, legs, trunk and total body.Conclusion
Once weekly of NMES RT evokes local positive changes in leg LM without reciprocating the continuous loss in LM or gain in FM in other regions and total body. Training was effective in increasing strength as well as fatigue resistance of the trained knee extensors. 相似文献Background:
Bone mass loss and muscle atrophy are the frequent complications occurring after spinal cord injury (SCI). The potential risks involved with these changes in the body composition have implications for the health of the SCI individual. Thus, there is a need to quantitate and monitor body composition changes accurately in an individual with SCI. Very few longitudinal studies have been reported in the literature to assess body composition and most include relatively small number of patients. The present prospective study aimed to evaluate the body composition changes longitudinally by DEXA in patients with acute SCI.Materials and Methods:
Ninety five patients with acute SCI with neurological deficits were evaluated for bone mineral content (BMC), body composition [lean body mass (LBM) and fat mass] by dual-energy X-ray absorptiometry during the first year of SCI.Results:
There was a significant decrease in BMC (P < 0.05) and LBM (P < 0.05) and increase in total body fat mass (TBFM) and percentage fat at infra-lesional sites. The average decrease was 14.5% in BMC in lower extremities, 20.5% loss of LBM in legs and 15.1% loss of LBM in trunk, and increase of 0.2% in fat mass in legs and 17.3% increased fat in the lower limbs at 1 year. The tetraplegic patients had significant decrease in arm BMC (P < 0.001), arm LBM (P < 0.01) and fat percentage (P < 0.01) compared to paraplegics. Patients with complete motor injury had higher values of TBFM and fat percentage, but comparable values of BMC and LBM to patients with incomplete motor injury.Conclusions:
Our findings suggest that there is a marked decrease in BMC and LBM with increase in adiposity during the first year of SCI. Although these changes depend on the level and initial severity of lesions, they are also influenced by the neurological recovery after SCI. 相似文献Objective
To compare two forms of device-specific training – body-weight-supported (BWS) ambulation on a fixed track (TRK) and BWS ambulation on a treadmill (TM) – to comprehensive physical therapy (PT) for improving walking speed in persons with chronic, motor-incomplete spinal cord injury (SCI).Methods
Thirty-five adult subjects with a history of chronic SCI (>1 year; AIS ‘C’ or ‘D’) participated in a 13-week (1 hour/day; 3 days per week) training program. Subjects were randomized into one of the three training groups. Subjects in the two BWS groups trained without the benefit of additional input from a physical therapist or gait expert. For each training session, performance values and heart rate were monitored. Pre- and post-training maximal 10-m walking speed, balance, muscle strength, fitness, and quality of life were assessed in each subject.Results
All three training groups showed significant improvement in maximal walking speed, muscle strength, and psychological well-being. A significant improvement in balance was seen for PT and TRK groups but not for subjects in the TM group. In all groups, post-training measures of fitness, functional independence, and perceived health and vitality were unchanged.Conclusions
Our results demonstrate that persons with chronic, motor-incomplete SCI can improve walking ability and psychological well-being following a concentrated period of ambulation therapy, regardless of training method. Improvement in walking speed was associated with improved balance and muscle strength. In spite of the fact that we withheld any formal input of a physical therapist or gait expert from subjects in the device-specific training groups, these subjects did just as well as subjects receiving comprehensive PT for improving walking speed and strength. It is likely that further modest benefits would accrue to those subjects receiving a combination of device-specific training with input from a physical therapist or gait expert to guide that training. 相似文献Objective
To study the relationship of waist circumference (WC) and bioelectrical impedance analysis (BIA) and degree of agreement between anthropometric index (AI) and BIA, using BIA as a reference or ‘gold standard’. The second objective is to study the relationship between body mass index (BMI) and BIA in subjects with spinal cord injury (SCI).Study design
Comparative cross-sectional study.Setting
Convenience sample at outpatient clinic of spinal cord center.Outcome measures
Estimation of obesity was made in 23 men with motor complete paraplegia (>1 year post-injury). Bland and Altman statistics were used to define level of agreement between AI and BIA, Pearson''s r to describe correlation between WC and BIA and BMI and BIA.Results
Good agreement between BIA and AI with a small systematic difference in fat mass (FM) (mean difference: −0.28%, Pearson''s r: 0.91) was found. The correlation between WC and the BIA (% FM) was very high (Pearson''s r: 0.83). The correlation between WC and BMI (% FM) was just over moderate (Pearson''s r: 0.51).Conclusion
AI seems to be a valid proxy measure to estimate obesity in males living with SCI. Measurement of obesity in persons with SCI based on WC is promising. BMI showed not to be valid to estimate obesity in persons with SCI. 相似文献Methods: A cross-sectional prospective cohort study with 7-day follow-up was conducted. Body composition, cardiorespiratory fitness and biomarkers of cardiometabolic health were measured in thirty-three participants with SCI (> 1 year post injury). Physical activity dimensions were objectively assessed over 7-days.
Results: Activity energy expenditure (r =.43), physical activity level (r =.39), and moderate-to-vigorous physical activity (MVPA) (r =.48) were significantly (P < 0.001) associated with absolute (L/min) peak oxygen uptake (?O2 peak). ?O2 peak was significantly higher in persons performing ≥150 MVPA minutes/week compared to <40 minutes/week (P?=?0.003). Individual physical activity dimensions were not significantly associated with biomarkers of cardiometabolic health. However, body composition characteristics (BMI, waist and hip circumference) showed significant (P < 0.04), moderate (r >.30) associations with parameters of metabolic regulation, lipid profiles and inflammatory biomarkers. Relative ?O2 peak (ml/kg/min) was moderately associated with only insulin sensitivity (r?=?0.37, P?=?0.03).
Conclusions: Physical activity dimensions are associated with cardiorespiratory fitness; however, stronger and more consistent associations suggest that poor cardiometabolic health is associated with higher body fat content. Given these findings, the regulation of energy balance should be an important consideration for researchers and clinicians looking to improve cardiometabolic health in persons with SCI. 相似文献