Energy Expenditure and Metabolism during Exercise in Persons with a Spinal Cord Injury

  • Price M
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Resting energy expenditure of persons with a spinal cord injury ({SCI}) is generally lower than that seen in able-bodied ({AB}) individuals due to the reduced amounts of muscle mass and sympathetic nervous system available. However, outside of clinical studies, much less data is available regarding. athletes with an {SCI}. In order to predict the energy expenditure of persons with {SCI}, the generation and validation of prediction equations in relation to specific levels of {SCI} and training status are required. Specific prediction equations for the {SCI} would enable a quick and accurate estimate of energy requirements. When compared with the equivalent {AB} individuals, sports energy expenditure is generally reduced in {SCI} with values representing 30-75% of {AB} values. The lowest energy expenditure values are observed for sports involving athletes with tetraplegia and where the sport is a static version of that undertaken by the {AB}, such as fencing. As with {AB} sports there is a lack of {SCI} data for true competition situations due to methodological constraints. However, where energy expenditure during field tests are predicted from laboratory-based protocols, wheelchair ergometry is likely to be the most appropriate exercise mode. The physiological and metabolic responses of persons with {SCI} are similar to those for {AB} athletes, but at lower absolute levels. However, the underlying mechanisms pertaining to substrate utilization appear to differ between the {AB} and {SCI}. Carbohydrate feeding has been shown to improve endurance performance in athletes with generally low levels of {SCI}, but no data have been reported for mid to high levels of {SCI} or for sport-specific tests of an intermittent nature. Further research within the areas reviewed may help to bridge the gap between what is known regarding {AB} athletes and athletes with {SCI} (and other disabilities) during exercise and also the gap between clinical practice and performance.

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  • Michael Price

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