Chronic activity-based therapy does not improve body composition, insulin-like growth factor-I, adiponectin, or myostatin in persons with spinal cord injury

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000236 · Published: January 1, 2015

Spinal Cord Injury Physiology Rehabilitation

Simple Explanation

This study investigated the effects of a 6-month activity-based therapy (ABT) program on body composition and certain metabolic markers in individuals with spinal cord injury (SCI). ABT included load bearing, resistance training, locomotor training, and functional electrical stimulation. The researchers measured body weight, body fat, fat-free mass (FFM), insulin-like growth factor-I (IGF-I), adiponectin, and myostatin at the beginning of the study and after 3 and 6 months of ABT. They found that ABT did not significantly improve body composition or alter the levels of IGF-I, adiponectin, or myostatin in this population. The findings suggest that chronic ABT, as implemented in this study, is not effective in reversing muscle atrophy or improving body fat in persons with SCI. Alternative exercise-based therapies may be needed to address these issues and minimize the health risks associated with SCI.

Study Duration

6 Months

Participants

17 men and women with SCI (mean age = 36.1 ± 11.5 years)

Evidence Level

Longitudinal exercise intervention

Key Findings

1
There was no significant change in body weight, percent body fat, or FFM of the leg, arm, or trunk across all subjects after 6 months of ABT.
2
Whole-body FFM declined significantly during the study period.
3
No significant changes were observed in IGF-I, adiponectin, or myostatin levels during the study.

Research Summary

This study examined the impact of chronic activity-based therapy (ABT) on body composition and metabolic markers in individuals with spinal cord injury (SCI). The results indicated that ABT did not significantly improve body composition, with a small decline in whole-body FFM observed. There were more robust changes seen in individuals with chronic or incomplete injury. The study concludes that alternative exercise modalities are needed to prevent deleterious changes in body composition in persons with acute, complete SCI, as ABT alone was not sufficient to reverse muscle atrophy or improve body fat.

Practical Implications

Need for Alternative Therapies

The findings suggest a need for alternative or supplementary exercise therapies to address muscle atrophy and body fat issues in SCI patients, especially those with acute and complete injuries.

Individualized Exercise Regimens

Exercise regimens should be individualized based on the type and duration of the injury, with a focus on incorporating more effective modalities like FES-assisted resistance training.

Comprehensive Management of Type II Diabetes Risk

Given the high risk of type II diabetes in SCI patients, comprehensive management strategies including effective exercise interventions are crucial for maintaining their health and quality of life.

Study Limitations

1
Heterogeneity in age, sex, and injury level/duration among participants
2
Lack of a non-exercising control group
3
Absence of measures such as fasting insulin, insulin sensitivity, or maximal oxygen uptake

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