Longitudinal study of body composition in spinal cord injury patients

Singh, Roop; Rohilla, Rajesh; Saini, Gaurav; Kaur, Kiranpreet

doi:10.4103/0019-5413.128760

Cited by 61 publications

(54 citation statements)

References 23 publications

(54 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The degree of neurological involvement has a significant effect on the wastage of the paravertebral muscle post-SCI [2]. We did not find any statistically significant differences between patients categorized as motor complete (ASIA A) and motor incomplete (ASIA B, C, or D) in the present study, and intergroup comparisons at different time points did not reveal any significant changes in the majority of the muscles studied.…”

Section: Discussioncontrasting

confidence: 68%

“…This injury causes immediate and, in some areas, permanent gravitational unloading, thus resulting in structural changes due to disuse and associated metabolic consequences. Osteoporosis and muscle atrophy are the frequently encountered complications of SCI [1,2], and these conditions occur rapidly after injury and are associated with several secondary complications. Inactivation and extreme unloading following SCI can lead to marked atrophy of the leg and thigh skeletal muscles within a few months of injury [3].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Magnetic Resonance Imaging of Trunk Musculature and Intervertebral Discs in Patients with Spinal Cord Injury with Thoracolumbar Vertebral Fractures: A Prospective Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

This study is a prospective clinical study. Purpose: This study aims to evaluate the characteristics of trunk musculature and intervertebral discs by using magnetic resonance imaging in patients with spinal cord injuries (SCIs) with thoracic and lumbar fractures. Overview of Literature: Muscle atrophy is an immediate consequence of SCI and is associated with secondary complications. At present, there are limited clinical data on muscle and disc responses to fractures of the thoracic and lumbar spine. Methods: A total of 51 patients with a mean age of 31.75±10.42 years who suffered traumatic SCI were included in this study. Complete neurological examinations (American Spinal Injury Association grading) and magnetic resonance imaging (MRI) were performed at the time of admission and at 3-6 months after injury to study the neurological status and disc and trunk parameters. The type of management (operative or conservative) was decided on the basis of clinical, radiological, and MRI evaluations, and a robust rehabilitation program was initiated. Results: Disc parameters including disc angle, skin angle, cross-sectional area (CSA), and disc height and trunk parameters (mean trunk width, mean trunk depth, and CSA of the lumbar muscles) decreased significantly (p<0.001) during the first 3 months after SCI. However, improvements were observed in disc and muscle parameters at the 6-month follow-up, but these parameters did not return to normal levels. Neither initial neurological status (complete vs. incomplete) nor type of management (operative vs. conservative) had a significant effect on these parameters. Conclusions: Spinal trauma leads to alterations in the morphology of the vertebral column, spinal cord, intervertebral discs, and paraspinal muscles in the initial phase of injury. The extent of these changes may determine the initial neurological deficit and subsequent recovery. Although this study did not identify any statistically significant effect of neurological status or management strategy on these parameters, rehabilitation was found to result in the improvement of these parameters in the later phase of recovery. Future studies are required to evaluate the exact causes of these alterations and the potential benefits of rehabilitation strategies and to minimize these changes.

show abstract

Section: Discussioncontrasting

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Magnetic Resonance Imaging of Trunk Musculature and Intervertebral Discs in Patients with Spinal Cord Injury with Thoracolumbar Vertebral Fractures: A Prospective Study

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…This data from DEXA measurements somewhat diverge from what is available from human clinical studies, that show human SCI patients gain fat and lose increased lean muscle mass, BMD, and BMC PI [38][39][40] . While female SCI animals began to show a difference in BMC, this divergence may indicate a limitation of the rat model to recapitulate these defects but also may be due to the difference in the degree of injury.…”

Section: Discussioncontrasting

confidence: 61%

A Long-Term Pilot Study on Sex and Spinal Cord Injury Shows Sexual Dimorphism in Functional Recovery and Cardio-Metabolic Responses

Ghnenis¹,

Burns²,

Osimanjiang³

et al. 2020

Sci Rep

View full text Add to dashboard Cite

More than a quarter of a million individuals in the US live with spinal cord injury (Sci). Sci disrupts neural circuitry to vital organs in the body. Despite severe incidences of long-term peripheral complications from Sci, the cardio-metabolic consequences and divergences in sex-related responses are not well described. We examined the effects of SCI on functional recovery, cardiac structure and function, body composition, and glucose metabolism on adult female and male Sprague Dawley (SD) rats. Sci was induced at T10 via contusion. Measured outcomes include behavioral assessment, body weight, dualenergy X-ray absorptiometry (DeXA) for body composition, echocardiography for cardiac structure and function, intraperitoneal glucose tolerance test (ipGtt) for glucose metabolism, insulin tolerance test (itt), and histology of cardiac structure at the endpoint. there was a decrease in body fat percentage in both sexes, with SCI females disproportionately affected in percent body fat change. Left ventricular internal diameter during systole (LViDs) was decreased in Sci females more than in Sci males. no significant differences in glucose metabolism were observed up to 20 weeks post-injury (PI). These data show significant cardio-metabolic differences as a consequence of SCI and, furthermore, that sex is an underlying factor in these differences.

show abstract

“…25,26 The loss of lean body mass following SCI is obligatory, 21 and it is also influenced by the neurological level of SCI. 38 Patients with tetraplegia often experience a greater loss of muscle mass compared with those with paraplegia, 38 which appears to reduce energy expenditure further. This was demonstrated in the studies by Yilmaz and Gorgey, in which REE was up to 370 kcal per day lower in tetraplegic compared with paraplegic patients.…”

Section: Discussionmentioning

confidence: 99%

Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review

et al. 2015

View full text Add to dashboard Cite

Background: Accurate estimation of energy needs is vital for effective nutritional management of individuals with spinal cord injury (SCI). Inappropriate energy prescription after SCI can compound the rates of malnutrition or obesity, increase the risk of complications and negatively influence outcomes. Energy requirements following SCI are not well understood, and there is currently no universally accepted method of estimating energy needs in clinical practice. Study design: This is a systematic literature review. Objectives: The objectives of this study were to investigate and compare the measured resting energy needs of adults with SCI across different phases of rehabilitation, and to identify appropriate energy prediction equations for use in SCI. Setting: This study was conducted in Australia. Methods: MEDLINE, EMBASE and CENTRAL databases were searched for studies published between 1975 and April 2015, identifying 298 articles. Full articles in English language of adults with SCI who were fasted for a minimum of 8 hours before undergoing indirect calorimetry to measure resting energy expenditure (REE) for at least 20 min were selected. On the basis of the inclusion criteria, 18 articles remained for data extraction. One author extracted information from all articles, and inter-rater reliability was tested in five articles. Results: REE across three phases of injury was assessed: acute, sub-acute and chronic. Few studies (n = 2) have investigated REE in the acute and sub-acute injury stages of SCI recovery. The factors influencing chronic energy needs in SCI patient populations are many and varied, and a valid predictive equation for use in SCI remains elusive. SCI is initially associated with catabolic conditions of trauma such as spinal shock and patients may be at risk of weight loss, malnutrition and pressure injuries. 1 In the long term, SCI results in marked body composition changes, specifically muscle atrophy below the level of injury and higher relative fat mass compared with people without SCI, 1-3 which may contribute to decreases in resting energy expenditure (REE). In an environment of reduced mobility, energy needs are further reduced, and there is an increased risk of weight gain and obesity-related chronic diseases. 4,5 To prescribe an appropriate daily energy intake, an individual's total daily energy expenditure (TDEE) must be determined. An individual's TDEE comprises three components, two of which may be considerably affected by SCI. Basal metabolic rate (BMR) is the minimum energy required for the basal processes of life, and it contributes the majority (~70%) of TDEE in a healthy person. 6 In the clinical literature, the term BMR is often used interchangeably with REE, and for the purpose of this review REE is defined as the energy expended in an awake, alert individual in a rested position following

show abstract

Longitudinal study of body composition in spinal cord injury patients

Cited by 61 publications

References 23 publications

Magnetic Resonance Imaging of Trunk Musculature and Intervertebral Discs in Patients with Spinal Cord Injury with Thoracolumbar Vertebral Fractures: A Prospective Study

Magnetic Resonance Imaging of Trunk Musculature and Intervertebral Discs in Patients with Spinal Cord Injury with Thoracolumbar Vertebral Fractures: A Prospective Study

A Long-Term Pilot Study on Sex and Spinal Cord Injury Shows Sexual Dimorphism in Functional Recovery and Cardio-Metabolic Responses

Investigation of measured and predicted resting energy needs in adults after spinal cord injury: a systematic review

Contact Info

Product

Resources

About