Exercise to Reduce Obesity in Spinal Cord Injury
| Status: | Completed |
|---|---|
| Conditions: | Obesity Weight Loss, Hospital, Orthopedic, Diabetes |
| Therapuetic Areas: | Endocrinology, Orthopedics / Podiatry, Other |
| Healthy: | No |
| Age Range: | 18 - 65 |
| Updated: | 11/18/2017 |
| Start Date: | May 2008 |
| End Date: | December 2011 |
The purpose of this proposal was to evaluate and compare the health benefits of using upper
extremity exercise versus functional electrical stimulation for lower extremity exercise. It
was our hypothesis that both Functional Electrical Stimulation Leg Cycle Ergometry (FES LCE)
exercise and voluntary Arm Crank Ergometry (ACE) upper extremity exercise would increase
whole body energy expenditure, thereby increasing muscle mass, insulin sensitivity, glucose
effectiveness and improving lipid profiles in adults with paraplegia.
extremity exercise versus functional electrical stimulation for lower extremity exercise. It
was our hypothesis that both Functional Electrical Stimulation Leg Cycle Ergometry (FES LCE)
exercise and voluntary Arm Crank Ergometry (ACE) upper extremity exercise would increase
whole body energy expenditure, thereby increasing muscle mass, insulin sensitivity, glucose
effectiveness and improving lipid profiles in adults with paraplegia.
Objective: Spinal cord injuries (SCI) predispose individuals to impaired fitness, obesity,
glucose intolerance and insulin resistance, placing them at greater risk for diabetes,
coronary artery disease, and upper extremity overuse syndrome as body weight increases. The
specific objectives for the current proposal were to compare the impact of FES (functional
electrical stimulation) lower extremity exercise versus upper extremity arm crank ergometry
on energy metabolism, body composition and fat deposition, insulin sensitivity, glucose
effectiveness, lower extremity bone mineral density and lipid profiles, in adults with
complete paraplegia. Research Plan: A randomized, baseline-controlled, prospective, 16-week
interventional trial was employed to assess the impact of FES LCE versus volitional arm crank
ergometry exercise on energy metabolism, body composition and fat deposition, insulin
sensitivity, glucose effectiveness, lower extremity bone mineral density and lipid profiles
in adults with complete paraplegia. Methods: Twenty-four 18-65 y.o. individuals with motor
complete T4-L2 SCI were assigned to either FES lower extremity exercise or upper extremity
arm crank ergometry to compare impact on energy expenditure, obesity, and insulin
sensitivity. Both groups were provided similar nutritional assessments and intervention.
Exercise training consisted of five, 40-minute sessions at 70% maximal heart rate (HRmax)
each week for a total of 16 weeks. Resting metabolic rate, exercise energy expenditure, body
composition by DXA, insulin sensitivity, glucose effectiveness, lipid profiles, and lower
extremity bone mineral density (BMD) were determined before and after 16-week exercise
interventions.
glucose intolerance and insulin resistance, placing them at greater risk for diabetes,
coronary artery disease, and upper extremity overuse syndrome as body weight increases. The
specific objectives for the current proposal were to compare the impact of FES (functional
electrical stimulation) lower extremity exercise versus upper extremity arm crank ergometry
on energy metabolism, body composition and fat deposition, insulin sensitivity, glucose
effectiveness, lower extremity bone mineral density and lipid profiles, in adults with
complete paraplegia. Research Plan: A randomized, baseline-controlled, prospective, 16-week
interventional trial was employed to assess the impact of FES LCE versus volitional arm crank
ergometry exercise on energy metabolism, body composition and fat deposition, insulin
sensitivity, glucose effectiveness, lower extremity bone mineral density and lipid profiles
in adults with complete paraplegia. Methods: Twenty-four 18-65 y.o. individuals with motor
complete T4-L2 SCI were assigned to either FES lower extremity exercise or upper extremity
arm crank ergometry to compare impact on energy expenditure, obesity, and insulin
sensitivity. Both groups were provided similar nutritional assessments and intervention.
Exercise training consisted of five, 40-minute sessions at 70% maximal heart rate (HRmax)
each week for a total of 16 weeks. Resting metabolic rate, exercise energy expenditure, body
composition by DXA, insulin sensitivity, glucose effectiveness, lipid profiles, and lower
extremity bone mineral density (BMD) were determined before and after 16-week exercise
interventions.
Inclusion Criteria:
Criteria for participation included men and women within the age range of 18-65 years old
with BMI>25 kg/m2 who have had T4-L2 Motor-Complete (ASIA A&B) SCI for duration of greater
than 12 months to ensure a homogenous sample.
Exclusion Criteria:
- persons who were unresponsive to surface neurostimulation
- had participated in an FES or ACE exercise (> 60 minutes/week) program within the past
3 months
- and those with known orthopedic limitations
- CAD
- diabetes mellitus (fasting glucose>126 or HgbA1c>7.0) or known family history
- hypothyroidism
- and/or renal disease were excluded from the study.
- Additionally, individuals with uncontrolled autonomic dysreflexia, recent (within 3
months) deep vein thrombosis, or pressure ulcers > Grade II were excluded.
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