Post-traumatic changes in energy expenditure and body composition in patients with acute spinal cord injury
Peter Felleiter, Joerg Krebs, Yvonne Haeberli, Wilma Schmid, Stefanie Tesini, Claudio Perret
Intensive Care Medicine, Swiss Paraplegic Centre Nottwil, 6207 Nottwil, Switzerland: E-mail: firstname.lastname@example.org
Study design: Prospective cohort study.
Objective: To investigate the changes in resting energy expenditure and body composition over time in a cohort of patients with spinal cord injury during acute treatment, rehabilitation, and 2 years after the end of rehabilitation.
Methods: Adult patients admitted for acute treatment and rehabilitation after traumatic spinal cord injury were recruited. Measurements of resting energy expenditure and body composition were scheduled at 2, 6, 10 and 14 weeks after spinal cord injury, at the end of rehabilitation, and 2 years later.
Results: Patients’ mean age was 38.8 years (standard deviation 14.0). Resting energy expenditure began to decrease up to the 10-week measurement (p = 0.02) and further decreased after the 130-week measurement (p < 0.001). Body weight was already decreased after the 6-week measurement (p < 0.01) and increased after the end of rehabilitation (p = 0.009). Percentage body fat mass showed similar changes.
Conclusion: After an initial decrease in resting energy expenditure, body weight and percentage of body fat, these values levelled off during the rehabilitation period. After the end of the rehabilitation period, body weight and body fat mass increased again to the baseline levels, whereas resting energy expenditure decreased further. These results suggest that rehabilitation programmes should focus on adapting to these foreseeable changes.
After a spinal cord injury, the muscle mass in the paralysed areas of the body decreases due to inactivity. We measured the changes in body weight, body composition and energy consumption in 24 patients during a period of 30 months after spinal cord injury. After a first decrease in body weight and body fat, the investigated patients slowly started to gain weight and body fat. The resting energy consumption was decreasing continuously during the observation period. The observed changes may increase the risk of cardiovascular and metabolic diseases. We therefore recommend to include nutrition counselling and continuous physical activity in patient education programs.
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