Obesity and high body fat levels are common in individuals with spinal cord injury (SCI) and highly associated with cardiovascular disease. Exercise has been shown to positively impact basal metabolic rate (BMR) and physical activity-associated energy expenditure (PAEE), thereby increasing total daily energy expenditure (TDEE). However, the long-term effects of exercise are poorly investigated in persons who use wheelchairs for mobility, and exercise recommendations are unclear for individuals with SCI. To date, health professionals tend to follow the exercise recommendations for able-bodied healthy adults when working with an individual with SCI.

This study aimed to verify the long-term effects of exercise on energy expenditure and various anthropometric variables. Thirteen individuals with SCI were split into two groups based on level of physical activity. If a participant exercised at least three times per week for a total of at least 150 minutes, they were placed in the exercise group (n=7). If the individual exercised less than 60 minutes weekly, they were placed in the sedentary group (n=6). All participants were required to make four visits to the clinic for various data collection, including: anthropometric data (mass, stature, waist circumference); BMR; peak oxygen consumption (VO2peak); urine samples collected over a two week period, and; self-report physical activity data. TDEE and body composition were measured using doubly-labeled water.

The study demonstrated that individuals who exercise at least 3 times per week for at least 150 minutes weekly (exercise group) showed significantly higher TDEE. The researchers also found that individuals that exercised less than 60 minutes per week (sedentary) had significantly higher percent body fat. The study found that, despite the severity of the spinal cord injury, the current guidelines recommended by the American Heart Association (AHA) and American College of Sports Medicine (ACSM) could positively impact TDEE and BMR in individuals with SCI. However, all improvements were modest. Future research is needed to determine a more specific approach to exercise dosage in individuals with SCI focusing on various components of exercise including volume, duration, and intensity.

Reference

Tanhoffer, R. A., Tanhoffer, A. IP., Raymond, J., Hills, A. P., & Davis, G. M.(2013). Exercise, energy expenditure and body composition in people with spinal cord injury.  Journal of Physical Activity and Health. Dec. 20 [Epub ahead of print]