scholarly journals Energy Expenditure Following Spinal Cord Injury: A Delicate Balance

2021 ◽  
Vol 27 (1) ◽  
pp. 92-99
Author(s):  
Gary J. Farkas ◽  
Alicia Sneij ◽  
David R. Gater
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Energy Expenditure ◽  
Metabolic Rate ◽  
Clinical Care ◽  
Accurate Determination ◽  
Caloric Intake ◽  
Standard Of Care ◽  
Cord Injury

Following a spinal cord injury (SCI), neurogenic obesity results from changes in body composition, physical impairment, and endometabolic physiology and when dietary intake exceeds energy expenditure. Given the postinjury reductions in lean body mass, sympathetic nervous system dysfunction, and anabolic deficiencies, energy balance is no longer in balance, and thereby an obesogenic environment is created that instigates cardiometabolic dysfunction. Accurate determination of metabolic rate can prevent excess caloric intake while promoting positive body habitus and mitigating obesity-related comorbidities. Metabolic rate as determined by indirect calorimetry (IC) has not been adopted in routine clinical care for persons with SCI despite several studies indicating its importance. This article reviews current literature on measured and predicted metabolic rate and energy expenditure after SCI and stresses the importance of IC as standard of care for persons with SCI.

scholarly journals A Primary Care Provider’s Guide to Diet and Nutrition After Spinal Cord Injury

2020 ◽  
Vol 26 (3) ◽  
pp. 197-202
Author(s):  
David R. Gater ◽  
Craig Bauman ◽  
Rachel Cowan
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Caloric Intake ◽  
Positive Energy ◽  
Body Composition Assessment ◽  
Nutrient Density ◽  
Cord Injury ◽  
Positive Energy Balance

Physiological changes that occur after spinal cord injury (SCI) are profound and affect almost every organ system in the human body. Energy balance is significantly altered due to motor paralysis, spasticity or flaccidity, neurogenic sarcopenia, neurogenic osteopenia, sympathetic nervous system disruption, and blunted anabolism. Energy expenditure is markedly reduced, whereas hypothalamic control of appetite and satiety is diminished, resulting in discordant energy intake. Ultimately, neurogenic obesity ensues as the result of a positive energy balance. Even though nutritional guidelines for persons with SCI have been available since 2009, the necessity for body composition assessment and total daily energy expenditure was insufficiently addressed such that most individuals with SCI continued in positive energy balance despite “adherence” to the guidelines. Macronutrients must be carefully assessed to optimize caloric intake, while micronutrient consumption may need to be supplemented in order to meet recommended daily allowances. Such a diet would emphasize foods with low caloric yet high nutrient density. This article reviews current literature regarding nutritional requirements for SCI and provides a straightforward plan for implementing more rigorous dietary interventions meant to address the obesity crisis in this especially vulnerable population.

scholarly journals Wearable Sensors in Ambulatory Individuals With a Spinal Cord Injury: From Energy Expenditure Estimation to Activity Recommendations

2019 ◽  
Vol 10 ◽  
Author(s):  
Werner L. Popp ◽  
Sophie Schneider ◽  
Jessica Bär ◽  
Philipp Bösch ◽  
Christina M. Spengler ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Energy Expenditure ◽  
Wearable Sensors ◽  
Cord Injury ◽  
Activity Recommendations

Energy Expenditure in Individuals with Spinal Cord Injury Quantified by Doubly Labeled Water and a Multi-Sensor Armband

2015 ◽  
Vol 12 (2) ◽  
pp. 163-170 ◽  
Author(s):  
Ricardo A. Tanhoffer ◽  
Aldre I.P. Tanhoffer ◽  
Jacqueline Raymond ◽  
Nathan A. Johnson ◽  
Andrew P. Hills ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Energy Expenditure ◽  
Doubly Labeled Water ◽  
Cord Injury

scholarly journals All-cause and cause-specific mortality following non-traumatic spinal cord injury: evidence from a population-based cohort study in Switzerland

Spinal Cord ◽  
2019 ◽  
Vol 58 (2) ◽  
pp. 157-164 ◽  
Author(s):  
A. Buzzell ◽  
◽  
J. D. Chamberlain ◽  
I. Eriks-Hoogland ◽  
K. Hug ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cohort Study ◽  
Clinical Care ◽  
Population Based ◽  
Future Research ◽  
Cord Injury ◽  
Specific Mortality ◽  
National Cohort

Abstract Study design Observational cohort study. Objective To benchmark all-cause and cause-specific mortality following NTSCI to the general population (GP). Setting Specialized rehabilitation centers in Switzerland. Methods Longitudinal data from the Swiss Spinal Cord Injury (SwiSCI) Medical Record study were probabilistically linked with cause of death (CoD) information from the Swiss National Cohort. Standardized mortality ratios (SMRs) were estimated for all-cause and cause-specific mortality. Competing risk frameworks were used to estimate the probability of death due to specific CoD. Results One thousand five hundred and one individuals were admitted for first rehabilitation with NTSCI between 1990–2011; CoD information was available for 454 individuals of the 525 individuals that died. Overall, the mortality rate for persons with NTSCI was 1.6 times greater than that of the GP. Deaths due to cardiovascular disease (39.8%), neoplasms (22%), and infection (9.9%) were most often reported. Individuals with an SCI due to a vascular etiology indicated the greatest burden of mortality from infection compared with the GP (SMR 5.4; 95% CI, 3.1 to 9.2). Conclusions Cause-specific SMRs varied according to etiology. This supports the need for targeted clinical care and follow-up. Cardiovascular disease, neoplasms, and infection, emerged as main causes of death following NTSCI and should thus be targets for future research and differential clinical management approaches.

Determination of lesion specific reference equations for respiratory function in individuals with spinal cord injury

2015 ◽  
Author(s):  
Anja M. Raab ◽  
Sonja De Groot ◽  
Marcel W.M. Post ◽  
David J. Berlowitz ◽  
Jacinthe Adriaansen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Respiratory Function ◽  
Specific Reference ◽  
Cord Injury ◽  
Reference Equations

Heart rate as a predictor of energy expenditure in people with spinal cord injury

2005 ◽  
Vol 42 (5) ◽  
pp. 617 ◽  
Author(s):  
Amy M. Hayes ◽  
Jonathan N. Myers ◽  
Monica Ho ◽  
Matthew Y. Lee ◽  
Inder Perkash ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Energy Expenditure ◽  
Cord Injury
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