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Cardiometabolic Syndrome in SCI: The Role of Physical Deconditioning and Evidence-Based Countermeasures

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The Physiology of Exercise in Spinal Cord Injury

Part of the book series: Physiology in Health and Disease ((PIHD))

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Abstract

Persons with spinal cord injuries and disorders (SCI/D) frequently experience component and coalesced health risks of the cardiometabolic syndrome (CMS). The CMS hazards of overweight/obesity, insulin resistance, hypertension, and dyslipidemia—the latter as depressed high-density lipoprotein cholesterol and elevated triglycerides—are strongly associated with physical deconditioning, which is common after SCI/D and worsens the prognosis for all-cause cardiovascular disease occurring early after SCI/D. Evidence supports a role for physical activity after SCI/D as an effective countermeasure to these risks, and often represents the first-line approach to CMS abatement. This evidence is supported by authoritative guidelines that recommend specific activities, frequencies, and activities of work. In many cases, the most effective exercise programming uses a combination of resistance and endurance maneuvers with limited rest taken between sets. As SCI/D is also associated with food intake that is excessive in calories and saturated fat, more comprehensive lifestyle management incorporating both exercise and nutrition represents a favored approach for overall health management. Irrespective of the interventional strategy, improved surveillance of the population for CMS risks and encouraged incorporation of moderate exercise and nutritional intake by health care professionals may play an important role in preservation of activity, optimal health, and preserved independence throughout the lifespan.

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Notes

  1. 1.

    http://www.cdc.gov/diabetes/prevention/pdf/curriculum.pdf

    http://www.cdc.gov/diabetes/prevention/recognition/curriculum.htm

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Authors and Affiliations

  1. Departments of Neurological Surgery, Physical Medicine & Rehabilitation, Physical Therapy, University of Miami, Miami, FL, USA

    Jennifer L. Maher Ph.D., David W. McMillan M.S. & Mark S. Nash Ph.D., FACSM

  2. Departments of Kinesiology and Sports Sciences, University of Miami, Miami, FL, USA

    Jennifer L. Maher Ph.D., David W. McMillan M.S. & Mark S. Nash Ph.D., FACSM

  3. The Miami Project to Cure Paralysis, University of Miami, Miami, FL, USA

    Jennifer L. Maher Ph.D., David W. McMillan M.S. & Mark S. Nash Ph.D., FACSM

  4. Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA

    Jennifer L. Maher Ph.D., David W. McMillan M.S. & Mark S. Nash Ph.D., FACSM

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  1. Jennifer L. Maher Ph.D.
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  2. David W. McMillan M.S.
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  3. Mark S. Nash Ph.D., FACSM
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Correspondence to Mark S. Nash Ph.D., FACSM .

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  1. Physical Medicine & Rehabilitation, Harvard Medical School, Spaulding Hospital Cambridge, Cambridge, Massachusetts, USA

    J. Andrew Taylor

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Maher, J.L., McMillan, D.W., Nash, M.S. (2016). Cardiometabolic Syndrome in SCI: The Role of Physical Deconditioning and Evidence-Based Countermeasures. In: Taylor, J. (eds) The Physiology of Exercise in Spinal Cord Injury. Physiology in Health and Disease. Springer, Boston, MA. https://doi.org/10.1007/978-1-4939-6664-6_10

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