title: Longitudinal study of body composition in spinal cord injury patients.
abstract: BACKGROUND
  Bone mass loss and muscle atrophy are the frequent complications occurring after spinal cord injury (SCI). The potential risks involved with these changes in the body composition have implications for the health of the SCI individual. Thus, there is a need to quantitate and monitor body composition changes accurately in an individual with SCI. Very few longitudinal studies have been reported in the literature to assess body composition and most include relatively small number of patients. The present prospective study aimed to evaluate the body composition changes longitudinally by DEXA in patients with acute SCI.
  
  
  METHODS
  Ninety five patients with acute SCI with neurological deficits were evaluated for bone mineral content (BMC), body composition [lean body mass (LBM) and fat mass] by dual-energy X-ray absorptiometry during the first year of SCI.
  
  
  RESULTS
  There was a significant decrease in BMC (P < 0.05) and LBM (P < 0.05) and increase in total body fat mass (TBFM) and percentage fat at infra-lesional sites. The average decrease was 14.5% in BMC in lower extremities, 20.5% loss of LBM in legs and 15.1% loss of LBM in trunk, and increase of 0.2% in fat mass in legs and 17.3% increased fat in the lower limbs at 1 year. The tetraplegic patients had significant decrease in arm BMC (P < 0.001), arm LBM (P < 0.01) and fat percentage (P < 0.01) compared to paraplegics. Patients with complete motor injury had higher values of TBFM and fat percentage, but comparable values of BMC and LBM to patients with incomplete motor injury.
  
  
  CONCLUSIONS
  Our findings suggest that there is a marked decrease in BMC and LBM with increase in adiposity during the first year of SCI. Although these changes depend on the level and initial severity of lesions, they are also influenced by the neurological recovery after SCI.
authors.affiliation: Department of Orthopaedic Surgery, Paraplegia Rehabilitation, Rohtak, Haryana, India.
authors.forename: Roop
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Orthopaedic Surgery, Paraplegia Rehabilitation, Rohtak, Haryana, India.
authors.forename: Rajesh K
authors.initials: RK
authors.lastname: Rohilla
authors.affiliation: Department of Orthopaedic Surgery, Paraplegia Rehabilitation, Rohtak, Haryana, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Saini
authors.affiliation: Department of Anaesthesiology Critical Care, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India.
authors.forename: Kiranpreet
authors.initials: K
authors.lastname: Kaur
keywords: Body composition; body mass index; dual-energy X-ray absorptiometry; paraplegia; spinal cord injuries; tetraplegia
references.citation: Arch Phys Med Rehabil. 1993 Jul;74(7):706-10
references.pmid: 8328891
references.citation: Spinal Cord. 1999 Jul;37(7):494-500
references.pmid: 10438116
references.citation: Paraplegia. 1995 Nov;33(11):674-7
references.pmid: 8584304
references.citation: Metabolism. 1994 Jun;43(6):749-56
references.pmid: 8201966
references.citation: Eur J Clin Invest. 1990 Jun;20(3):330-5
references.pmid: 2114994
references.citation: Spinal Cord. 1997 May;35(5):266-74
references.pmid: 9160449
references.citation: Paraplegia. 1988 Oct;26(5):293-301
references.pmid: 3205570
references.citation: Arch Phys Med Rehabil. 1986 Jul;67(7):445-50
references.pmid: 3729689
references.citation: Paraplegia. 1992 Oct;30(10):697-703
references.pmid: 1448297
references.citation: J Spinal Cord Med. 2001 Winter;24(4):266-77
references.pmid: 11944785
references.citation: Spinal Cord. 1998 Nov;36(11):790-6
references.pmid: 9848488
references.citation: J Bone Miner Res. 2004 Jan;19(1):48-55
references.pmid: 14753736
references.citation: Phys Ther. 1994 Jan;74(1):50-60
references.pmid: 8265728
references.citation: Osteoporos Int. 1999;10(2):123-7
references.pmid: 10501792
references.citation: Arch Phys Med Rehabil. 1994 Sep;75(9):946-50
references.pmid: 8085927
references.citation: Eur J Appl Physiol Occup Physiol. 1999 Sep;80(4):373-8
references.pmid: 10483809
references.citation: Hum Biol. 1984 Sep;56(3):459-73
references.pmid: 6489991
references.citation: J Spinal Cord Med. 2006;29(5):489-500
references.pmid: 17274487
references.citation: J Spinal Cord Med. 2007;30 Suppl 1:S97-104
references.pmid: 17874694
references.citation: J Spinal Cord Med. 2007;30 Suppl 1:S127-39
references.pmid: 17874698
references.citation: Clin Endocrinol (Oxf). 2006 Nov;65(5):555-65
references.pmid: 17054455
references.citation: Spinal Cord. 1996 Dec;34(12):736-41
references.pmid: 8961432
references.citation: J Appl Physiol (1985). 2003 Dec;95(6):2398-407
references.pmid: 12909613
references.citation: Spinal Cord. 1998 Sep;36(9):637-40
references.pmid: 9773449