Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: A model of premature aging

Bauman, William A.; Spungen, Ann M.

doi:10.1016/0026-0495(94)90126-0

Cited by 363 publications

(304 citation statements)

References 41 publications

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“…This is an exciting finding given that physical activity level is modifiable, and that disordered glucose metabolism is disproportionately prevalent in people with SCI compared with the ablebodied. 1,2 Previous studies in people with SCI have shown relationships between glycemia and neurological lesion level 3 and between fasting glucose and physical activity levels. 9 However, because lesion level may be associated with physical activity level, 11 it was not clear in these studies whether the influence of physical activity on disordered carbohydrate metabolism was independent of lesion level.…”

Section: Discussionmentioning

confidence: 98%

“…1,2 It has been suggested that the extent of neurological impairment after SCI is an important determinant of these impairments; participants with complete tetraplegia (TETRA) had higher levels of serum glucose and plasma insulin during a 2-h oral glucose tolerance test (OGTT) and higher incidence of IGT or diabetes than participants with either incomplete TETRA or complete or incomplete paraplegia (PARA). 3 The suggestion that greater neurological deficit is associated with poorer glucose tolerance may be explained by the consequences of denervation such as skeletal muscle atrophy 4,5 and altered fiber-type proportions, 6,7 with the volume of muscle affected related to level and completeness of the neurological lesion.…”

Section: Introductionmentioning

confidence: 99%

“…Manns et al (2005) 9 found an inverse relationship between physical activity and fasting glucose, although there was no relationship been physical activity and 2-h glucose after an OGTT or markers of insulin resistance, including fasting insulin and the homeostasis model assessment. In addition, Bauman and Spungen (1994) 1 found that aerobic capacity was related to insulin sensitivity in participants with PARA. However, it is unknown whether in these relationships, physical activity and fitness levels are simply surrogate measures of neurological impairment.…”

Section: Introductionmentioning

confidence: 99%

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Glucose tolerance and physical activity level in people with spinal cord injury

et al. 2010

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Study design: Cross-sectional, observational study. Objectives: To evaluate the associations of physical activity and neurological lesion level with glucose tolerance in people with spinal cord injury (SCI). Setting: New South Wales, Australia. Methods: Twenty-five people (5 women, 20 men) with SCI (46 months post-injury) aged between 18 and 65 years were recruited. Exclusion criteria included known coronary heart disease, stroke or diabetes. Participants underwent an oral glucose tolerance test. Fasting and 2-h plasma glucose concentrations were classified according to the World Health Organization categories of glycemia. Participants also completed the Physical Activity Scale for Individuals with Physical Disabilities and mean MET-hours day À1 was calculated. Associations with the 2-h plasma glucose concentration were calculated through multiple and stepwise regressions. Results: Participants presented with complete or incomplete tetraplegia (n ¼ 11 TETRA) or complete or incomplete paraplegia (n ¼ 14 PARA) with neurological lesion levels ranging from C3/4 to T12. Mean 2-h plasma glucose was 7.13 ± 2.32 mmol l À1 . Nine participants had disordered glycemia (n ¼ 6 TETRA; n ¼ 3 PARA) and the remaining participants had normal glucose tolerance. Those participants with normal glucose tolerance participated in more moderate-vigorous and strength exercise and undertook more non-exercise-related mobility than those with disordered glycemia. Physical activity and age, but not lesion level were independent determinants of 2-h plasma glucose concentration (r ¼ 0.683, P ¼ 0.001), explaining 47% of the variance. Conclusion: Physical activity level is independently associated with glucose tolerance in people with SCI. Non-exercise activity may also be important for maintaining normal glycemia.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Glucose tolerance and physical activity level in people with spinal cord injury

et al. 2010

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“…1 ± 4 Findings show that people with SCI have a three to ®ve times higher risk of developing DM than the able-bodied population. 5 ± 9 Bauman and Spungen 5 demonstrated that 22% of subjects with SCI had DM as compared to only 6% in an able-bodied control group. Sixty-two per cent of subjects with quadriplegia and 50% of those with paraplegia had abnormal glucose tolerance compared to 18% of controls.…”

Section: Introductionmentioning

confidence: 98%

Improved glucose tolerance and insulin sensitivity after electrical stimulation-assisted cycling in people with spinal cord injury

Jeon

Steadward

et al. 2002

Spinal Cord

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Design: Longitudinal training. Objectives: The purpose was to determine the e ect of electrical stimulation (ES)-assisted cycling (30 min/day, 3 days/week for 8 weeks) on glucose tolerance and insulin sensitivity in people with spinal cord injury (SCI). Setting: The Steadward Centre, Alberta, Canada. Methods: Seven participants with motor complete SCI (®ve males and two females aged 30 to 53 years, injured 3 ± 40 years, C5 ± T10) underwent 2-h oral glucose tolerance tests (OGTT, n=7) and hyperglycaemic clamp tests (n=3) before and after 8 weeks of training with ESassisted cycling. Results: Results indicated that subjects' glucose level were signi®cantly lower at 2 h OGTT following 8 weeks of training (122.4+10 vs 139.9+16, P=0.014). Two-hour hyperglycaemic clamps tests showed improvement in all three people for glucose utilisation and in two of three people for insulin sensitivity. Conclusions: These results suggested that exercise with ES-assisted cycling is bene®cial for the prevention and treatment of Type 2 diabetes mellitus in people with SCI.

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“…Adherence to exercise is an important issue for individuals with SCI since they are at an increased risk of various secondary health complications, such as cardiovascular disease 9 and type II diabetes, 10 which are somewhat reversible with exercise training. 11,12 Further, if their exercise habits became less regular, it was unknown how long their previously accrued benefits, in terms of pain and stress reduction and enhanced PQOL, would persist.…”

Section: Introductionmentioning

confidence: 99%

Maintenance of exercise participation in individuals with spinal cord injury: effects on quality of life, stress and pain

et al. 2003

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Study design: Follow-up study of seven individuals with spinal cord injury (SCI) who completed a 9-month randomized control trial (RCT) of exercise training. Objective: In a 9-month RCT conducted in our lab, individuals with SCI who participated in a twice-weekly supervised exercise training reported greater perceived quality of life (PQOL), and less stress and pain than a nonexercising control cohort. The present follow-up study examined the voluntary continuation of exercise training after the study ended and the persistence of the accrued psychosocial benefits. Setting: Centre for Health Promotion and Rehabilitation, McMaster University, Hamilton, Ontario, Canada. Methods: Five men and two women (age 42.373.6 years) with SCI (C5-T12; ASIA A-D 12.778.2 years postinjury) were invited to continue supervised exercise training twice weekly at the completion of the 9-month RCT. Exercise adherence, PQOL, stress and bodily pain were measured at a 3-month follow-up and were compared to values obtained at baseline, and at 3, 6 and 9 months during the intervention. Results: There was a significant decrease in adherence at the 3-month follow-up compared to the overall 9-month adherence rate (42.7 versus 80.6%, respectively; Po0.01). There was also a significant decrease in PQOL (Po0.05) and a trend for increased pain (P ¼ 0.07) and stress (P ¼ 0.12), at follow-up compared to the end of the 9-month trial. Finally, there was a significant negative correlation between pain at the conclusion of the RCT and exercise adherence over the 3-month follow-up period (r ¼ À0.91; Po0.01).

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Disorders of carbohydrate and lipid metabolism in veterans with paraplegia or quadriplegia: A model of premature aging

Cited by 363 publications

References 41 publications

Glucose tolerance and physical activity level in people with spinal cord injury

Glucose tolerance and physical activity level in people with spinal cord injury

Improved glucose tolerance and insulin sensitivity after electrical stimulation-assisted cycling in people with spinal cord injury

Maintenance of exercise participation in individuals with spinal cord injury: effects on quality of life, stress and pain

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