Denervation impacts muscle quality and knee bone mineral density after spinal cord injury

Alazzam, Ahmad M.; Goldsmith, Jacob A.; Khalil, Refka E.; Khan, Mumtaz; Gorgey, Ashraf S.

doi:10.1038/s41393-023-00885-3

Cited by 9 publications

(6 citation statements)

References 42 publications

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“…In a recent study by Alazzam et al. comparing muscle quality and body composition between matched innervated and denervated males, authors noted an approximately 10 kg difference in total LBM (Alazzam, Goldsmith, et al., 2023). Notably, differences in body composition (FFM, LM, & FM) between innervated and denervated SCI individuals are important to consider when using SCI‐specific equations that were derived from individuals with UMN SCI.…”

Section: Discussionmentioning

confidence: 99%

“…Notably, differences in body composition (FFM, LM, & FM) between innervated and denervated SCI individuals are important to consider when using SCI‐specific equations that were derived from individuals with UMN SCI. Additionally, body composition differences warrant the need for additional research into the effects of LMN injury and metabolism, considering that individuals with LMN injury are estimated to account for nearly 25% of the SCI population (Alazzam, Goldsmith, et al., 2023; Chandrasekaran et al., 2020). In contrast, AB‐specific equations by Cunningham et al., Nelson et al., and Owen et al.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, a LMN injury results in extensive skeletal muscle atrophy, fibrillations in muscles, and infiltration of both intramyocellular fat and intramuscular fat (IMF) (Carraro et al., 2015; Chandrasekaran et al., 2020). A recent report demonstrated that muscle cross‐sectional area was lower by 38%–61% following a LMN compared to SCI in persons with upper motor neuron (UMN) injuries (Alazzam, Goldsmith, et al., 2023). Further, UMN injuries are due to disruption in the spinal cord, which can be characterized by loss of voluntary motor control, hyperreflexia, and increased muscle spasticity (Doherty et al., 2002).…”

Section: Introductionmentioning

confidence: 99%

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Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Alazzam,

Gorgey

2024

Physiological Reports

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Basal metabolic rate (BMR) measurement is time consuming and requires specialized equipment. Prediction equations allow clinicians and researchers to estimate BMR; however, their accuracy may vary across individuals with chronic spinal cord injury (SCI). The objective of this study was to investigate the validity of SCI‐specific equations as well as able‐bodied (AB) prediction equations in individuals with upper motor neuron (UMN), lower motor neuron (LMN), and females with SCI. Twenty‐six men and women with chronic SCI (n = 12 innervated males, n = 6 innervated females, n = 8 denervated males) participated in this cross‐sectional study. BMR values were measured by indirect calorimetry. Body composition (dual‐energy X‐ray absorptiometry and anthropometrics) assessment was conducted. AB‐prediction equations [Cunningham, Nelson, Owen, Harris and Benedict, Mifflin, Schofield, Henry] and SCI‐specific equations [Chun and Nightingale & Gorgey] were used to estimate and validate BMR. The accuracy of AB‐specific FFM equations in predicting BMR was evaluated using Bland–Altman plots, paired t‐tests, and error metrics. Measured BMR for innervated males, females, and denervated males was 1436 ± 213 kcal/day, 1290 ± 114, and 1597 ± 333 kcal/day, respectively. SCI‐specific equations by Chun et al., Nightingale & Gorgey, and AB‐specific FFM equations accurately predicted BMR for innervated males. For the denervated males, Model 4 equation by Nightingale & Gorgey was not different (p = 0.18), and Bland–Altman analyses showed negative mean bias but similar limits of agreement between measured and predicted BMR for the SCI‐specific equations and AB‐specific FFM equations. We demonstrated that SCI‐specific equations accurately predicted BMR for innervated males but underpredicted it for denervated males. The Model 4 equation by Nightingale & Gorgey accurately estimated BMR in females with SCI. Findings from the current study will help to determine caloric needs in different sub‐groups of SCI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Alazzam,

Gorgey

2024

Physiological Reports

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“…Individuals with neurological injuries like SCI experience significant changes in BC, increasing the risk of secondary health conditions, including increased FM, decreased LM, and reduced BMD (Alazzam et al, 2023;Mcmillan et al, 2021). These changes occur rapidly after the injury, including skeletal muscle atrophy and intramuscular fat accumulation below the level of injury (Raguindin et al, 2021).…”

Section: Body Compositionmentioning

confidence: 99%

Impact of detraining on the health of individuals with spinal cord injury: a systematic review

Almada,

Santos,

Venturini

et al. 2024

Cuad. Ed. Desar.

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Introduction: Spinal cord injury (SCI) is a debilitating condition that causes motor, physiological, and sensory impairments, potentially leading to permanent disability, increased morbidity, and mortality, ultimately impacting an individual's quality of life (QoL). Physical exercise emerges as an effective alternative to mitigate these consequences and uphold the autonomy and QoL for this population. Detraining (DT), defined as the partial or total loss of adaptations induced by physical training in response to its complete interruption or insufficient stimulus, represents a significant concern. The objective of this systematic review was to conduct a comprehensive literature review regarding the current state of knowledge on the potential impacts of DT on the health of individuals with SCI. Method: The search was conducted on PubMed, Web of Science, Embase, SPORTDiscus, and Cochrane databases using relevant English terms (("Detraining") AND ("Spinal Cord Injury")) and their synonyms. Due to the limited number of studies addressing this topic, no specific time frame was set for study eligibility. Results: The literature search was performed in November 2023, yielding 42 results, from which 15 remained after removing duplicates. Two articles were excluded following title analysis. Thirteen abstracts were reviewed, and 7 were excluded, leaving 6 articles for full analysis. Due to the nature of the studies, a meta-analysis was not conducted. Conclusion: DT resulted in alterations in body composition (BC), including increased body fat and reduced muscle mass, especially following the interruption of testosterone-associated training. Additionally, the cessation of training impacted the metabolic profile, leading to changes in glucose, lipids, and insulin sensitivity. Furthermore, hemodynamic variables, such as blood pressure (BP) and heart rate (HR), underwent changes, elevating the risk of cardiovascular complications. Regarding cardiorespiratory components, there was a decline in peak oxygen consumption (VO2peak) following the DT period. Halting exercise can lead to detrimental health consequences, underscoring the imperative of maintaining consistent physical training for these individuals.

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“…Beyond structural loading, multiple factors, including an increased age, increased time since SCI, and lower body mass index, may be contributory risk factors to SCI [ 44 , 45 ]. Likewise, post-menopausal bone loss may exacerbate the skeletal effects following an SCI.…”

Section: Risk Factors In Sci Individualsmentioning

confidence: 99%

Rehabilitation: Neurogenic Bone Loss after Spinal Cord Injury

Leone,

Shields,

Haque

et al. 2023

Biomedicines

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Osteoporosis is a common skeletal disorder which can severely limit one’s ability to complete daily tasks due to the increased risk of bone fractures, reducing quality of life. Spinal cord injury (SCI) can also result in osteoporosis and sarcopenia. Most individuals experience sarcopenia and osteoporosis due to advancing age; however, individuals with SCI experience more rapid and debilitating levels of muscle and bone loss due to neurogenic factors, musculoskeletal disuse, and cellular/molecular events. Thus, preserving and maintaining bone mass after SCI is crucial to decreasing the risk of fragility and fracture in vulnerable SCI populations. Recent studies have provided an improved understanding of the pathophysiology and risk factors related to musculoskeletal loss after SCI. Pharmacological and non-pharmacological therapies have also provided for the reduction in or elimination of neurogenic bone loss after SCI. This review article will discuss the pathophysiology and risk factors of muscle and bone loss after SCI, including the mechanisms that may lead to muscle and bone loss after SCI. This review will also focus on current and future pharmacological and non-pharmacological therapies for reducing or eliminating neurogenic bone loss following SCI.

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Denervation impacts muscle quality and knee bone mineral density after spinal cord injury

Cited by 9 publications

References 42 publications

Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Validation of basal metabolic rate equations in persons with innervated and denervated chronic spinal cord injury

Impact of detraining on the health of individuals with spinal cord injury: a systematic review

Rehabilitation: Neurogenic Bone Loss after Spinal Cord Injury

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