People with spinal cord injury (SCI) are at greater risk
of developing diabetes and other problems because of limited activity
levels, slower metabolism related to the injury and associated weight
gain. Researchers leading a new study at Shepherd Center hope to change
this.
The study, titled “Obesity/Overweight in Persons with
Early and Chronic SCI: A Randomized Multi-Center Lifestyle
Intervention,” aims to determine whether exercise alone, or in
combination with nutritional counseling and specific dietary changes,
can help participants lose weight, thereby, lowering their risk for
diabetes and heart disease.
“We are trying to prevent diabetes, and though we are
early in the study, some of our participants are already losing
weight,” said Elizabeth Gonzalez, study coordinator. “You can see the
happiness they feel as a result. It’s very fulfilling.”
Laura Hawkins, an exercise therapist at Shepherd Center,
added that protecting against diabetes is just one benefit.
“Participants can also more easily propel themselves, move
around and do wheelchair transfers. They report a better quality of
life overall,” she said.
Lamont McLeod, 35, of Sugar Hill, Ga., has already noticed
a big difference. He sustained a C-5 to -6 SCI in a car accident in
2010 on his way to see the last ultrasound of his expected youngest
child. Now, he is in month four of the yearlong exercise program.
“I’m gaining much more strength and range of motion,” he
said. “My arms used to get so tired and sore so quickly, but I can now
hold my utensils and even playfully wrestle a bit with my 3-year-old.”
Study participants are randomly assigned to one of two
groups – the exercise program or the exercise program plus diet
changes, which involves meeting with a dietitian, learning about
portions and calories, and keeping a food log. During the initial
three-month assessment period, participants maintain their usual eating
and exercise habits. Over the next six months, all study participants
will undergo exercise conditioning with a trainer, and half will also
attend 16 education sessions about how to control body weight and adopt
what is known as the Mediterranean diet – a diet that focuses on fresh
fruits and vegetables, whole grains, lean meats and fish, and olive
oil. This diet has been shown to lower the risk of diabetes and heart
disease in other populations. In the final six months, participants
will keep up with the same routine on their own either at Shepherd
Center or at home.
Researchers assess participants’ strength monthly and
periodically conduct fitness testing. They also collect dietary and
clinical information, including cholesterol, blood sugar and blood
pressure levels.
So far, Hawkins said Lamont has improved dramatically. He
was only able to lift a single pound weight with his right (more impaired)
hand at the start, and now he is already up to seven pounds. She,
Gonzalez and the research team hope participants will continue to use
the skills and healthful behaviors they are learning well beyond the
study period.
“Just like the rest of us, it’s hard to find the time,”
Hawkins said. “But when they can see the tangible benefits, it’s a real
motivator. For example, being able to go up the ramp of the parking
deck without getting out of breath and being in better shape generally
makes life easier.”
“A lot of people in my situation get diabetes, high
cholesterol or blood pressure because we aren’t as active as we used to
be, and it’s important to try to prevent these heath issues,” explained
Lamont, who recently returned to work as a real estate broker. “I’m
learning there are a lot of activities I can do from the wheelchair.”
The 15-month study is funded by the United States
Department of Defense, a grant awarded to principal investigator Mark
Nash, Ph.D., at the University of Miami. Shepherd Center is
collaborating with Nash and will enroll 12 participants. Deborah
Backus, P.T., Ph.D. is principal investigator at Shepherd.
The 45-minute program – done three times a week – includes
hand cycling and a complete circuit of exercises including:
Military/overhead press
Horizontal rows
Chest flies
Bicep curls
Lateral pull downs
Tricep dips
By Amanda Crowe, MA, MPH
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