Resting energy expenditure during spinal cord injury rehabilitation and utility of fat-free mass-based energy prediction equations: a pilot study.

IF 0.7 Q4 CLINICAL NEUROLOGY Spinal Cord Series and Cases Pub Date : 2024-10-02 DOI:10.1038/s41394-024-00682-x
Amy N Nevin, Sridhar S Atresh, Angela Vivanti, Leigh C Ward, Ingrid J Hickman
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Abstract

Study design: Longitudinal observational study. Measurements were undertaken between weeks 4-6 post-spinal cord injury (SCI), repeated at week 8 and every 4 weeks thereafter until week 20 or rehabilitation discharge, whichever occurred first.

Objectives: Observe variation in measured resting energy expenditure (REE) and body composition in males undergoing SCI rehabilitation, compare REE with SCI-specific prediction equations incorporating fat-free mass (FFM), and explore the prevalence of clinical factors that may influence individual REE.

Setting: Spinal Injuries Unit, Brisbane, Queensland, Australia.

Methods: Indirect calorimetry was used to measure REE and bioimpedance spectroscopy to assess body composition. Four SCI-specific FFM-based REE and basal metabolic rate (BMR) prediction equations were compared to measured REE. A clinically significant change in REE was defined as +/- 10% difference from the week 4-6 measurement. Clinical factors that may affect REE variations were collected including infection, pressure injuries, autonomic dysreflexia, spasticity, and medications.

Results: Fifteen people participated (mean age 35 ± 13 years, 67% paraplegic). There was no statistically significant change in mean REE, weight, or body composition, and the Chun and Nightingale BMR prediction equations performed best (rc > 0.8 at all time points). One-third of participants had >10% change in REE on 11 occasions, with clinical factors not consistently associated with the observed changes.

Conclusion: During SCI rehabilitation, mean REE, weight, and body composition remain unchanged, and FFM-based BMR prediction equations may be an acceptable alternative to indirect calorimetry. Future research designs should avoid single indirect calorimetry measures as snapshot data may not represent typical REE in this population.

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脊髓损伤康复期间的静息能量消耗和基于去脂质量的能量预测方程的实用性:一项试点研究。
研究设计:纵向观察研究。在脊髓损伤(SCI)后第 4-6 周进行测量,第 8 周重复测量,此后每 4 周测量一次,直至第 20 周或康复出院(以先发生者为准):观察接受脊髓损伤(SCI)康复治疗的男性静息能量消耗(REE)测量值和身体成分的变化,将REE与SCI特异性预测方程(包含去脂质量(FFM))进行比较,并探索可能影响个体REE的临床因素的普遍性:方法:采用间接热量测定法测量脊髓损伤患者的 REE:方法:采用间接量热法测量 REE,生物阻抗光谱法评估身体成分。将四种基于 SCI 特定 FFM 的 REE 和基础代谢率 (BMR) 预测方程与测得的 REE 进行了比较。与第 4-6 周的测量值相比,REE 的临床重大变化定义为 +/- 10% 的差异。收集了可能影响 REE 变化的临床因素,包括感染、压伤、自主神经反射障碍、痉挛和药物:15 人参加了测量(平均年龄 35 ± 13 岁,67% 截瘫)。平均 REE、体重或身体成分均无统计学意义上的显著变化,Chun 和 Nightingale BMR 预测方程表现最佳(所有时间点的 rc 均大于 0.8)。三分之一的参与者在 11 个场合的 REE 变化大于 10%,临床因素与观察到的变化并不一致:结论:在 SCI 康复期间,平均 REE、体重和身体成分保持不变,基于 FFM 的 BMR 预测方程可能是间接热量测定法的一种可接受的替代方法。未来的研究设计应避免采用单一的间接热量测量法,因为快照数据可能无法代表这类人群的典型 REE。
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来源期刊
Spinal Cord Series and Cases
Spinal Cord Series and Cases Medicine-Neurology (clinical)
CiteScore
2.20
自引率
8.30%
发文量
92
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