Body Composition According to Spinal Cord Injury Level: A Systematic Review and Meta-Analysis

The level of injury is linked with biochemical alterations and limitations in physical activity among individuals with spinal cord injury (SCI), which are crucial determinants of body composition. We searched five electronic databases from inception until 22 July 2021. The pooled effect estimates were computed using random-effects models, and heterogeneity was calculated using I2 statistics and the chi-squared test. Study quality was assessed using the Newcastle–Ottawa Scale. We pooled 40 studies comprising 4872 individuals with SCI (3991 males, 825 females, and 56 sex-unknown) in addition to chronic SCI (median injury duration 12.3 y, IQR 8.03–14.8). Individuals with tetraplegia had a higher fat percentage (weighted mean difference (WMD) 1.9%, 95% CI 0.6, 3.1) and lower lean mass (WMD −3.0 kg, 95% CI −5.9, −0.2) compared to those with paraplegia. Those with tetraplegia also had higher indicators of central adiposity (WMD, visceral adipose tissue area 0.24 dm2 95% CI 0.05, 0.43 and volume 1.05 L 95% CI 0.14, 1.95), whereas body mass index was lower in individuals with tetraplegia than paraplegia (WMD −0.9 kg/mg2, 95% CI −1.4, −0.5). Sex, age, and injury characteristics were observed to be sources of heterogeneity. Thus, individuals with tetraplegia have higher fat composition compared to paraplegia. Anthropometric measures, such as body mass index, may be inaccurate in describing adiposity in SCI individuals.

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Are Body Composition, Strength, and Functional Independence Similarities Between Spinal Cord Injury Classifications? A Discriminant Analysis

Journal of Sport Rehabilitation ◽

10.1123/jsr.2018-0244 ◽

2020 ◽

Vol 29 (3) ◽

pp. 277-281

Author(s):

Rodrigo Rodrigues Gomes Costa ◽

Rodrigo Luiz Carregaro ◽

Frederico Ribeiro Neto

Keyword(s):

Body Mass Index ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Body Composition ◽

Discriminant Analysis ◽

Body Mass ◽

Spinal Injury ◽

Functional Independence ◽

Fat Percentage ◽

Cord Injury

Context:There seems to be no consensus on which aspects better distinguish the different levels of spinal cord injury regarding body composition, strength, and functional independence.Objective:The study aimed to determine which variables better differentiate tetraplegia (TP) from paraplegia and high paraplegia (HP) from low paraplegia (LP).Design:Cross-sectional study.Setting:Rehabilitation hospital network.Patients:Forty-five men with spinal cord injury, n = 15 for each level (TP, HP, and LP) causing complete motor impairment (American Spinal Injury Association Impairment Scale: A or B) were enrolled in the study.Main Outcome Measures:The 1-maximum repetition test, functional independence measure, spinal cord independence measure, and body composition (skinfold sum, body fat percentage, and body mass index) were assessed. Discriminant analysis was carried out using the Wilks lambda method to identify which strength and functional variables can significantly discriminate subjects for injury classification (TP, HP, and LP).Results:The discriminant variable for TP versus HP was body mass index and for TP versus LP was 1-maximum repetition (P ≤ .05). There were no variables that discriminated HP versus LP.Conclusions:The discriminant variables for TP versus HP and TP versus LP were body mass index and 1-maximum repetition, respectively. The results showed that HP and LP are similar for strength and functional variables.

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Body Mass Index and Body Composition Measures by Dual X-Ray Absorptiometry in Patients Aged 10 to 21 Years With Spinal Cord Injury

Journal of Spinal Cord Medicine ◽

10.1080/10790268.2007.11754612 ◽

2007 ◽

Vol 30 (sup1) ◽

pp. S97-S104 ◽

Cited By ~ 38

Author(s):

Craig M. McDonald ◽

Allison L. Abresch-Meyer ◽

Mindy Dopier Nelson ◽

Lana M. M.Widman

Keyword(s):

Body Mass Index ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Body Composition ◽

Body Mass ◽

X Ray ◽

Cord Injury

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Altered Body Composition Affects Resting Energy Expenditure and Interpretation Of Body Mass Index In Chiloren With Spinal Cord Injury

Journal of Spinal Cord Medicine ◽

10.1080/10790268.2004.11753781 ◽

2004 ◽

Vol 27 (sup1) ◽

pp. S24-S28 ◽

Cited By ~ 27

Author(s):

Amanda Liusuwan ◽

Lana Widman ◽

Ted Abresch ◽

Craig M. McDonald

Keyword(s):

Body Mass Index ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Body Composition ◽

Energy Expenditure ◽

Body Mass ◽

Resting Energy Expenditure ◽

Cord Injury ◽

Resting Energy

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Factors influencing body composition in persons with spinal cord injury: a cross-sectional study

Journal of Applied Physiology ◽

10.1152/japplphysiol.00729.2002 ◽

2003 ◽

Vol 95 (6) ◽

pp. 2398-2407 ◽

Cited By ~ 218

Author(s):

Ann M. Spungen ◽

Rodney H. Adkins ◽

Charles A. Stewart ◽

Jack Wang ◽

Richard N. Pierson ◽

...

Keyword(s):

Body Mass Index ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Body Composition ◽

Body Mass ◽

Lean Mass ◽

The Body ◽

Control Group ◽

Cord Injury ◽

Total Body

To determine the body composition differences across age, 133 men with chronic spinal cord injury (SCI) (66 with tetraplegia, 67 with paraplegia) were compared with an age-, height-, and ethnicity-matched able-bodied male reference population ( n = 100) using two different dual-energy X-ray absorptiometry densitometers. The effects of duration of injury, level, and completeness of lesion were analyzed in the SCI population. Independent of age, total body and regional lean mass were lower and fat mass was higher in persons with SCI compared with controls. The SCI group was 13 ± 1% (means ± SE) fatter per unit of body mass index (kg/m2) compared with the control group ( P < 0.0001). Advancing age was strongly associated with less lean mass and greater adiposity in those with SCI, whereas it was mildly related in the controls. Total body and regional arm and trunk, but not leg, lean tissues were lower in subjects with SCI, across all ages, than in the controls. In summary, persons with SCI were fatter for any body mass index and demonstrated significantly less lean and more adipose tissues for any given age compared with controls.

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