title: Improvement in weight loss and ambulation outcomes after gastric sleeve surgery for a person with chronic motor-incomplete tetraplegia: clinical case report.
abstract: OBJECTIVE
  To measure body mass index (BMI) and ambulation changes for a morbidly obese, 47-year-old man with chronic motor-incomplete tetraplegia after gastric sleeve surgery.
  
  
  METHODS
  A morbidly obese man, BMI=44 kg m(-)(2), with chronic C5 AIS D tetraplegia underwent elective gastric sleeve surgery. Assessment of BMI and function via the 6-minute walk test (6MWT), 10-meter walk test (10MWT) and ambulation parameters (CIR Systems/GAITRite, Franklin, NJ, USA) was performed preoperatively and at 12, 24, 36 and 52 weeks postoperatively, and additionally after 3 weeks of both a prescribed coached (3 × /week facility based) and a non-coached (3 × /week home based) walking program initiated at 52 weeks. A step activity monitor assessed daily ambulation preoperatively, prior to and during the third and sixth week of the walking program.
  
  
  RESULTS
  Results included a 34.3% peak BMI decrease at 52 weeks post surgery and a peak increase in 6MWT distance of 58% at 52 weeks post surgery, 10MWT preferred speed of 56% at 55 weeks and step activity monitor of 82% at 58 weeks post surgery. At 58 weeks, gait data demonstrated a decrease in double limb stance of 38% and decrease in base of support of 72%.
  
  
  CONCLUSIONS
  This empirical case assessment of BMI and functional mobility before and after gastric sleeve surgery may encourage further investigation into mobility and general health effects post gastric procedures for people with chronic motor-incomplete spinal cord injury.
authors.affiliation: National Institutes of Health, Bethesda, MD, USA.
authors.forename: J R
authors.initials: JR
authors.lastname: Perreault
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, USA.|University of Maryland Rehabilitation and Orthopaedic Institute, Baltimore, MD, USA.
authors.forename: P R
authors.initials: PR
authors.lastname: Geigle
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, USA.|University of Maryland Rehabilitation and Orthopaedic Institute, Baltimore, MD, USA.|VA Maryland Healthcare System, Baltimore, MD, USA.
authors.forename: P H
authors.initials: PH
authors.lastname: Gorman
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD, USA.
authors.forename: W H
authors.initials: WH
authors.lastname: Scott
mesh_terms: D050110:Bariatric Surgery / Q000379:methods*; D015992:Body Mass Index; D005500:Follow-Up Studies; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000209:etiology* / Q000601:surgery*; D011782:Quadriplegia / Q000150:complications* / Q000601:surgery; D016138:Walking; D015431:Weight Loss / Q000502:physiology*