Category: Spinal Cord Injury; Spinal Cord Injury
Objective : To investigate the impact of body mass index (BMI) status on functional outcomes during initial hospital care among persons with spinal cord injury (SCI).
Design : Multicenter cross-sectional study.
Setting : Eighteen SCI Model Systems Centers throughout the United States.
Participants (or Animals, Specimens, Cadavers) : 5,236 adults with SCI (1,083 incomplete paraplegia, 1,116 complete paraplegia, 2,332 incomplete tetraplegia, 705 complete tetraplegia), enrolled in the National SCI Model Systems Database during 2006 – 2018.
Interventions : Not applicable.
Main Outcome Measure(s) : Change in FIM self-care, mobility and motor total scores between rehabilitation admission and discharge.
Results : The prevalence of underweight (BMI < 18.5), overweight (25.0 - 29.9), and obesity (≥ 30.0) was 4.0%, 31.1% and 23.4%, respectively. Mean changes in self-care, mobility and motor total scores were 13.4 ± 8.3, 13.3 ± 6.8 and 28.5 ± 16.7. Regardless of neurological categories, people with obesity had less mobility and motor total gains at discharge than their normal weight counterparts, ranging from -3.3 (complete paraplegia) to -0.9 units (complete tetraplegia) for mobility and from -7.2 (complete paraplegia) to -2.1 units (incomplete tetraplegia) for motor total. Within tetraplegia group, people with underweight had less gains in mobility and motor total than those with normal weight, with greater differences in score gains observed among those with incomplete tetraplegia. Obesity was associated with less gains in self-care at discharge in all neurological categories except incomplete tetraplegia group.
Conclusions : Obesity and underweight tend to impact functional outcomes during inpatient rehabilitation, suggesting that BMI should be considered for acute rehabiliation care of people with SCI. Future study should explore the impact of BMI on long-term outcomes.