Spinal Cord Injury Clinical Trial
Official title:
Exercise Treatment of Obesity-Related Secondary Conditions in Adults With Paraplegia
This hypothesis-driven study will investigate effects of physical activity with or without a nutrient supplement known to increase body lean mass in adults with chronic paraplegia who have clusters of obesity and obesity-related secondary complications.
Obesity and obesity-related secondary complications are pandemic health hazards that are
highly prevalent among persons with spinal cord injuries (SCI). Accumulation of body fat
disposes persons with SCI to accelerated endocrine and cardiovascular diseases, as well as
pain, functional decline, and diminished health-related quality of life (HRQoL). While use
of combined resistance and endurance exercise by persons without disability can remedy many
of the problems associated with these disorders, their widespread use for persons with
spinal cord injuries (SCI) must first satisfy scientific burdens of effectiveness.
The investigators have adopted the term "obesity-related secondary complications" to
describe accumulation of body fat clustering with other secondary CVD risks, while
recognizing that a threshold criterion for diagnosis of obesity in persons with SCI remains
ill-defined. For purposes of this proposal, the "-related" part of the term confers physical
deconditioning, hypertension, fasting dyslipidemia, post-prandial lipemia (PPL), and
impaired insulin sensitivity, all of which have been reported in persons with SCI.
Contextualized, any of these risks occurring independently or in clusters would be cause for
immediate therapeutic lifestyle intervention (TLI), if not frank medical treatment. Given
our early understanding of effective treatments for these risks, any improvement in their
severity would be CVD risk-reducing and thus life-benefiting and function-preserving.
The investigators expect that the research findings will improve the understanding of risks
for obesity and obesity-related secondary complications so that future interventions can be
better targeted, identify an exercise intervention that can attend to current health risks,
clarify whether nutrient supplementation improves risk-lessening benefits of exercise,
identify exercise timing and intensities that best enhance fat utilization, and expand the
understanding of the interrelated nature of risk factors after SCI.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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