title: Behavioral intervention, exercise, and nutrition education to improve health and fitness (BENEfit) in adolescents with mobility impairment due to spinal cord dysfunction.
abstract: OBJECTIVE
  Determine the effects of a nutrition education and exercise intervention on the health and fitness of adolescents with mobility impairment due to spinal cord dysfunction from myelomeningocele and spinal cord injury. Subjects participated in a 16-week intervention consisting of a behavioral approach to lifestyle change, exercise, and nutrition education to improve fitness (BENEfit) program. Participants were given a schedule of aerobic and strengthening exercises and attended nutrition education and behavior modification sessions every other week along with their parent(s).
  
  
  METHODS
  Twenty adolescents (aged 11-18 years, mean 15.4 +/- 2.2 years) with spinal cord dysfunction.
  
  
  METHODS
  Subjects were tested immediately prior to starting and upon completion of the program. Aerobic fitness was measured using a ramp protocol with an arm ergometer. Heart rate and oxygen uptake were measured. Values at anaerobic threshold and maximum oxygen uptake were recorded. Peak isokinetic arm and shoulder strength were determined with a dynamometer. Body composition was estimated with dual-energy x-ray absorptiometry. Serum chemistry included measures of cholesterol, high-density lipoprotein, low-density lipoprotein, and triglycerides.
  
  
  RESULTS
  Fourteen individuals completed all testing sessions. There was no significant overall change in weight, body mass index, body mass index z-scores, or serum chemistry. Overall, there was a significant increase in whole body lean tissue without a concomitant increase in whole body fat. Fitness measures revealed a significant increase in maximum power output, work efficiency as measured by the amount of power output produced aerobically, and resting oxygen uptake. Strength measurements revealed a significant increase in shoulder extension strength and a trend towards increased shoulder flexion strength. There were no significant changes in high-density lipoprotein, low-density lipoprotein, total cholesterol, or triglycerides.
  
  
  CONCLUSIONS
  The BENEfit program shows promise as a method for improving the health and fitness of adolescents with mobility impairments who are at high risk for obesity and obesity-related health conditions.
authors.affiliation: Shriners Hospitals for Children Northern California, Sacramento, California, USA.
authors.forename: Rungsinee Amanda
authors.initials: RA
authors.lastname: Liusuwan
authors.forename: Lana M
authors.initials: LM
authors.lastname: Widman
authors.forename: Richard Ted
authors.initials: RT
authors.lastname: Abresch
authors.forename: Allan J
authors.initials: AJ
authors.lastname: Johnson
authors.forename: Craig M
authors.initials: CM
authors.lastname: McDonald
mesh_terms: D000293:Adolescent; D001521:Behavior Therapy / Q000379:methods*; D001823:Body Composition; D002648:Child; D015444:Exercise; D005260:Female; D006339:Heart Rate; D006801:Humans; D008074:Lipoproteins; D008297:Male; D009069:Movement Disorders / Q000209:etiology / Q000378:metabolism / Q000534:rehabilitation*; D053581:Muscle Strength Dynamometer; D010101:Oxygen Consumption; D010349:Patient Compliance; D010806:Physical Education and Training; D010809:Physical Fitness / Q000502:physiology*; D013118:Spinal Cord Diseases / Q000150:complications
chemical_list: D008074:Lipoproteins