FET significantly reduced disability and improved voluntary grasping beyond the effects of considerable conventional upper extremity therapy in individuals with tetraplegia.

BUCHHOLZ, ANDREA C., COLLEEN F. MCGILLIVRAY, AND PAUL B. PENCHARZ. Physical activity levels are low in free-living adults with chronic paraplegia. Obes Res. 2003;11:563-570. Objectives: To compare physical activity levels (PALs) of free-living adults with chronic paraplegia with World Health Organization recommendations and to compare energy expenditure between persons with complete vs. incomplete paraplegia. Research Methods and Procedures: Twenty-seven euthyroid adults (17 men and 10 women) with paraplegia (12.5 Ϯ 9.5 years since onset; 17 with complete lesions and 10 with incomplete lesions) participated in this cross-sectional study. Resting metabolic rate was measured by indirect calorimetry and total daily energy expenditure (TDEE) by heart rate monitoring. PAL was calculated as TDEE/resting metabolic rate. Total body water was measured by deuterium dilution and fat-free mass (FFM) and fat mass (FM) by calculation (FFM ϭ total body water/0.732; FM ϭ weight Ϫ FFM). Obesity was defined using the following percentage FM cutoffs: men 18 to 40 years Ͼ22% and 41 to 60 years Ͼ25%; and women 18 to 40 years Ͼ35% and 41 to 60 years Ͼ38%. Results: Nineteen subjects (70.4%; 13 men and six women) were obese. Fifteen subjects (56%) engaged in structured physical activity 1.46 Ϯ 0.85 times during the observation period for a mean of 49.4 Ϯ 31.0 minutes per session. Despite this, mean PAL of the group was 1.56 Ϯ 0.34, indicative of limited physical activity. TDEE was 24.6% lower in subjects with complete paraplegia (2072 Ϯ 505 vs. 2582 Ϯ 852 kcal/d, p ϭ 0.0372). Discussion: PAL of the group was low, indicating that persons with paraplegia need to engage in increased frequency, intensity, and/or duration of structured physical activity to achieve a PAL Ն1.75 and, thereby, to offset sedentary activities of daily living.

FFM, BCM, and RMR, but not obligatory TEF, are lower in paraplegics than in control subjects. RMR does not differ between control and paraplegic subjects after adjustment for FFM, indicating similar metabolic activity in the fat-free compartment of the body.