Weight change after spinal cord injury

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1179/2045772314Y.0000000264 · Published: January 1, 2017

Spinal Cord Injury Nutrition & Dietetics Rehabilitation

Simple Explanation

Individuals with spinal cord injuries (SCI) often face a higher risk of obesity compared to the general population. This is due to factors like reduced mobility and changes in metabolism. Obesity can lead to further health complications such as cardiovascular disease and pressure ulcers, impacting their quality of life. Following a SCI, individuals typically experience initial weight loss due to the body's response to trauma. However, as the body stabilizes, caloric needs decrease, increasing the risk of weight gain. Therefore, it's important to manage nutrition and weight after the initial injury phase. This study examined weight changes in individuals with SCI one year after their injury. The findings suggest that weight management strategies should be implemented early to prevent unhealthy weight changes, especially among at-risk groups.

Study Duration

1 year

Participants

1094 individuals with spinal cord injury

Evidence Level

Cohort study

Key Findings

1
The study found that, on average, individuals experienced a slight decrease in BMI during the first year after SCI. However, this varied depending on initial weight status.
2
Individuals classified as overweight or obese during rehabilitation tended to lose weight during the first year after SCI, with the amount of weight loss varying by sex, education, neurological level, and the presence of vertebral injury.
3
Individuals classified as underweight or normal weight during rehabilitation tended to gain weight during the first year after SCI, with the greatest increase among individuals of Hispanic origin, other marital status, specific age groups, and those with less than a high school education.

Research Summary

This study investigated weight changes in 1094 individuals with SCI one year post-injury. Data were collected from 16 Spinal Cord Injury Model Systems (SCIMS) within the National Spinal Cord Injury Database. The study found an overall decrease in BMI, with overweight/obese individuals losing weight and underweight/normal weight individuals gaining weight. Weight change varied based on demographic and clinical factors. The authors conclude that weight management strategies should be addressed early in rehabilitation to mitigate potential for unhealthy weight change, particularly among at-risk groups identified in the study.

Practical Implications

Targeted Interventions

Healthcare professionals should implement targeted weight management interventions during rehabilitation and outpatient visits, especially for individuals at risk of unhealthy weight changes.

Risk Factor Awareness

Healthcare providers should be aware of the risk factors associated with weight gain and loss after SCI, such as neurological impairment level, age, ethnicity, marital status, and education level.

Personalized Nutrition Plans

Develop personalized nutrition and physical activity plans to address the specific needs of individuals with SCI, considering their baseline weight status and individual risk factors.

Study Limitations

1
Lack of body composition assessment (fat vs. muscle mass).
2
Exclusion of a significant number of individuals, potentially introducing selection bias.
3
Baseline body weight was obtained during rehabilitation, not at the time of injury.

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