Category: Spinal Cord Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
Objective : To determine the association between SCIM scores and testosterone level, total lean body mass (TLBM) and bone mass in males with chronic spinal cord disease related paralysis.
This is a cross-sectional study involving medical records review and prospective data collection from males aged 18-65 years with spinal cord related paralysis seen in one specialized academic center between January 1, 2005 and April 30th 2015. Body composition measures, testosterone level and severity of injury from the International Standards for Neurological Classification of Spinal Cord Injury examination and Spinal Cord Independence Measure (SCIM) scores, measured within 6 months around dual energy absorbtiometry (DXA) date were recorded.
Setting : Academic, specialized spinal cord injury center
Participants (or Animals, Specimens, Cadavers) : males aged 18-65 years with spinal cord related paralysis seen in one specialized academic center between January 1, 2005 and April 30th 2015
Interventions : n/a
Main Outcome Measure(s) : SCIM, bone mass, lean muscle mass
Of 373 individuals, 285 had traumatic injuries, 189 had tetraplegia and 99 had neurologically complete injuries. 130 of them had normal testosterone. Persons with paraplegia had greater SCIM total scores compared to persons with tetraplegia. With every decile increase in TLBM index, SCIM total score increased an average of 9 % among persons with tetraplegia, but no significant change in SCIM scores was observed among persons with paraplegia. Bone mass correlated with lean body mass.
More muscle mass is associated with better function among persons with tetraplegia. The association is not present among persons with paraplegia, who in general, retain significantly greater functional abilities. Testosterone level correlates with bone and lean body mass. Further research examining the interaction between injury duration, body composition, testosterone level and exposure to structured rehabilitation over time is warranted to understand how TLBM may be used as a predictor of outcomes.
Cristina Sadowsky– Clinical Director International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, Maryland
Seung-Ho Bae– Student, Johns Hopkins University, Leesburg, Virginia
Julio Ojea Quintana– Student, Johns Hopkins University, Baltimore, Maryland