title: Physical activity levels are low in free-living adults with chronic paraplegia.
abstract: OBJECTIVE
  To compare physical activity levels (PALs) of free-living adults with chronic paraplegia with World Health Organization recommendations and to compare energy expenditure between persons with complete vs. incomplete paraplegia.
  
  
  METHODS
  Twenty-seven euthyroid adults (17 men and 10 women) with paraplegia (12.5 +/- 9.5 years since onset; 17 with complete lesions and 10 with incomplete lesions) participated in this cross-sectional study. Resting metabolic rate was measured by indirect calorimetry and total daily energy expenditure (TDEE) by heart rate monitoring. PAL was calculated as TDEE/resting metabolic rate. Total body water was measured by deuterium dilution and fat-free mass (FFM) and fat mass (FM) by calculation (FFM = total body water/0.732; FM = weight - FFM). Obesity was defined using the following percentage FM cutoffs: men 18 to 40 years >22% and 41 to 60 years >25%; and women 18 to 40 years >35% and 41 to 60 years >38%.
  
  
  RESULTS
  Nineteen subjects (70.4%; 13 men and six women) were obese. Fifteen subjects (56%) engaged in structured physical activity 1.46 +/- 0.85 times during the observation period for a mean of 49.4 +/- 31.0 minutes per session. Despite this, mean PAL of the group was 1.56 +/- 0.34, indicative of limited physical activity. TDEE was 24.6% lower in subjects with complete paraplegia (2072 +/- 505 vs. 2582 +/- 852 kcal/d, p = 0.0372).
  
  
  CONCLUSIONS
  PAL of the group was low, indicating that persons with paraplegia need to engage in increased frequency, intensity, and/or duration of structured physical activity to achieve a PAL >/=1.75 and, thereby, to offset sedentary activities of daily living.
authors.affiliation: Department of Nutritional Sciences, University of Toronto and The Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Andrea C
authors.initials: AC
authors.lastname: Buchholz
authors.forename: Colleen F
authors.initials: CF
authors.lastname: McGillivray
authors.forename: Paul B
authors.initials: PB
authors.lastname: Pencharz
mesh_terms: D000293:Adolescent; D000328:Adult; D001481:Basal Metabolism; D001823:Body Composition; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004734:Energy Metabolism; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000150:complications; D010264:Paraplegia / Q000209:etiology / Q000503:physiopathology*; D012621:Seasons; D013119:Spinal Cord Injuries / Q000150:complications