Evidence-based and heuristic approaches for customization of care in cardiometabolic syndrome after spinal cord injury

The Journal of Spinal Cord Medicine, 2012 · DOI: 10.1179/2045772312Y.0000000034 · Published: September 1, 2012

Spinal Cord Injury Cardiovascular Science Rehabilitation

Simple Explanation

This review discusses cardiometabolic syndrome (CMS) in individuals with spinal cord injuries (SCIs), which includes risks like obesity, high triglycerides, low HDL cholesterol, hypertension, and high blood sugar. These risks can lead to heart disease. The article suggests a systematic way to assess and manage these risks through lifestyle changes, medication, and personalized care plans. The article emphasizes using both evidence-based treatments and heuristic approaches (based on experience and intuition) to customize care. Lifestyle interventions, like diet and exercise, are recommended as a primary prevention strategy. When these interventions are not enough, medications are suggested based on established guidelines. The main goal is to provide a framework for managing CMS in people with SCI so they can lead healthier, more active lives. This involves identifying dietary and activity shortfalls, and encouraging lifestyle changes for both individuals with SCI and their healthcare providers.

Study Duration

Not specified

Participants

Persons with spinal cord injuries (SCIs)

Evidence Level

Review article

Key Findings

1
Persons with SCI commonly have component and coalesced health risks of cardiometabolic syndrome (CMS).
2
Physical inactivity is highly prevalent among persons with SCI, but physical activity has a beneficial impact on metabolic health, primarily on fasting lipids.
3
Lifestyle therapies incorporating decreased caloric intake and increased daily caloric expenditure effectively serve as first-line treatments for CMS.

Research Summary

This article describes a systematic procedure for individualized CMS risk assessment after SCI, and emphasizes evidence-based and intuition-centered countermeasures to disease. Customization of dietary and exercise plans then follow, identifying shortfalls in diet and activity patterns, and ways in which these healthy lifestyles can be more substantially embraced by both stakeholders with SCI and their health care providers. The over-arching purpose of the monograph is to create an operational framework in which existing evidence-based approaches or heuristic modeling becomes best practice.

Practical Implications

Personalized Care Plans

Customizing care plans based on individual needs and lifestyle, incorporating both evidence-based and intuitive approaches.

Aggressive Primary Prevention

Implementing therapeutic lifestyle interventions (TLIs) as a routine plan for primary prevention in individuals with SCI.

Pharmacotherapy when needed

Using pharmacotherapies according to authoritative standards when lifestyle interventions are unsuccessful.

Study Limitations

1
Data examining effects of specific dietary interventions in persons with SCI are very limited.
2
An existing body of evidence strongly supports health benefits of physical activity for persons with SCI, it remains insufficient to provide a unified recommendation for this specific disability population.
3
Most studies on alcohol intake use self-report data, which has limitations such as recall bias and underreporting.

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