A LIFELONG STRUGGLE: People who have suffered spinal cord injuries are at higher risk for obesity than those who haven’t. Because they’re often confined to a wheelchair, the paralyzed have a hard time exercising at a rate fast enough to burn excess calories. That isn’t the only reason they struggle to keep weight off. After injury to the spinal cord, individuals usually have a slower metabolic rate or a slower speed at which they burn calories. In addition to obesity, those with spinal cord injuries are at increased risk for related conditions like glucose intolerance, insulin resistance, diabetes and coronary artery disease.
UNIQUE NUTRITION: Patients can combat these risks by adjusting their diet to their lifestyle. Craig Hospital recommends patients with paraplegia, or no use of their legs, maintain a body weight about 5 percent to 10 percent lower than that of non-disabled people of the same height. For those with quadriplegia, or no use of their arms and legs, that number should be 10 percent to 15 percent lower than non-disabled people of the same height. A healthy quadriplegic needs about 10.3 calories per day for each pound of body weight. That means for a 150-pound healthy quadriplegic, 1,545 calories per day is ideal. A healthy paraplegic needs about 12.7 calories for each pound of body weight.
EXERCISE FOR THE PARALYZED: Those with spinal cord injuries can also reduce their risk of weight-related conditions through exercise. Resistance training can shape muscles, and those confined to a wheelchair can use resistance bands to do elbow and leg extensions; shoulder and trunk rotations; and back, neck and shoulder pull downs. Strength training with free weights, fitness machines and dumbbells are also practical for the wheelchair-bound. The Wheelchair Site says strength training should not be attempted until resistance training becomes easy. It’s important to use proper posture, gradually increase the size of weights and warm up for 5 to 10 minutes before doing this kind of exercise.
A newer way of exercising uses an electric muscle stimulating training system called ERGYS 2. One of the first people to use the system was Christopher Reeve. One study showed patients who were paralyzed from the chest or waist down saw an average 25-percent increase in oxygen uptake and a 37-percent increase in their heart-pumping volume after eight weeks of using the machine. The ERGYS 2 is a stationary bike that features straps for patients’ legs and feet. Electrodes trigger muscles in the patient’s thigh and seat to contract and relax. Other research is ongoing to compare the effectiveness of exercising the legs using functional electrical stimulation (FES) with exercising the arms using a crank for weight management. Each type of exercise will be evaluated to determine its impact on the energy expenditure, obesity and insulin sensitivity of patients with spinal cord injuries. The exercise regimen consists of five, 40-minute sessions at 70 percent maximal heart rate each week.