Metabolic and Physiologic Changes in Spinal Cord Injury Following a Diet and Exercise Intervention

Abstract

0532 Obesity is a contributing risk factor to many health concerns for the able bodied as well as disabled population. Reduction of body weight in this population can be important for the reduction of secondary health concerns including diabetes, cardiovascular health, pressure ulcers, and repetitive stress injuries to the upper limbs incurred from manual propulsion and transfers. Purpose: Determine the efficacy of weight management techniques on physiologic and metabolic parameters in an obese spinal cord injured population. Methods: Four female and five male participants (45+/−4.6 yrs, 84.5+/−14.3kg, 1.72+/−.13m, injury level ranged from T6-L1) were asked to complete a maximal exercise test on a SCI-FIT upper body ergometer. Following a 1 minutes unloaded workload, resistance was increased by 12 watts every minute while pedaling at 60 rpm. Metabolic data were collected via Cosmed K4b2 portable metabolic unit. Participants were randomly assigned to either diet and exercise (n = 5), diet only (n = 2), or control (n = 2). Participants were re-tested after 12 weeks. Participants in the diet and exercise (DE) group received weekly nutritional counseling and three 20 minute exercise sessions on the SCI-Fit UBE. Workload during training sessions were adjusted to maintain target heart rate of 80% of maximal heart rate recorded during initial exercise test. Participants assigned to the diet (D) group received weekly nutritional counseling sessions for 12 weeks. Participants in the diet and control (C) groups were asked to maintain their normal levels of physical activity for the 12 week period. Results: Both the DE and D groups demonstrated weight loss (DE 81.1 +/− 13.3kg vs. 74.8 +/− 11.8kg, D 104.5+/−3.1kg vs. 97.7 +/− 0.6kg), although neither were significant the diet only group demonstrated a trend towards signficance in weight loss. The DE group (6.3+/−1.4 vs 7.7+/− 0.7) demonstrated a trend towards significance in VO2 to body surface area ratio. Conclusion: The more important assessment of changes due to weight loss may be in the area of VO2 to body surface area due to the difficulty in assessing lower extremity muscle mass in the SCI population. A combination of diet and exercise in the SCI population demonstrates a positive trend in this parameter.