People with spinal cord injury face multiple barriers to physical fitness in functional, psychological, and architectural domains. Identification of these barriers can facilitate the participation of individuals with spinal cord injury in an exercise program, improving long-term health and wellness.

A prospective study of injuries affecting 50 highly competitive young female gymnasts was conducted over a period of 1 year. Many of the findings of this investigation were consistent with previous studies and suggest particular injury trends in women's gymnastics. These results included injury location, injury severity, nature of onset, event, and activity at the time of injury. Some of the descriptive results, however, provided information that was heretofore unreported or inconsistent with previous investigations. These findings involved injury rate, reinjury rate, time loss, injury type, hours of practice, and incidence of physician-seen injuries. Some of these findings were disturbing and echo concerns registered in the professional literature. In particular, the reinjury rate is alarming and points to the need for complete rehabilitation before return to full participation. The results of the analytic component of the study alluded to the potential role of competitive level and maturation rate in the profile of the injury-prone gymnast. Specifically, rapid periods of growth and advanced levels of training and competition appeared to be related to injury proneness. Pursuant to the descriptive and analytic results of the investigation, recommendations for injury prevention and continued research are made.

Background/Objective: To determine the effects of spasticity on anthropometrics, body composition (fat mass [FM] and fat-free mass [FFM]), and metabolic profile (energy expenditure, plasma glucose, insulin concentration, and lipid panel) in individuals with motor complete spinal cord injury (SCI). Methods: Ten individuals with chronic motor complete SCI (age, 33 ± 7 years; BMI, 24 ± 4 kg/m 2 ; level of injury, C6-T11; American Spinal Injury Association A and B) underwent waist and abdominal circumferences to measure trunk adiposity. After the first visit, the participants were admitted to the general clinical research center for body composition (FFM and FM) assessment using dual energy x-ray absorptiometry. After overnight fasting, resting metabolic rate (RMR) and metabolic profile (plasma glucose, insulin, and lipid profile) were measured. Spasticity of the hip, knee, and ankle flexors and extensors was measured at 6 time points over 24 hours using the Modified Ashworth Scale. Results: Knee extensor spasticity was negatively correlated to abdominal circumferences (r 5 20.66, P 5 0.038). After accounting for leg or total FFM, spasticity was negatively related to abdominal circumference (r 5 20.67, P 5 0.03). Knee extensor spasticity was associated with greater total %FFM (r 5 0.64; P 5 0.048), lower %FM (r 5 20.66; P 5 0.03), and lower FM to FFM ratio. Increased FFM (kg) was associated with higher RMR (r 5 0.89; P 5 0.0001). Finally, spasticity may indirectly influence glucose homeostasis and lipid profile by maintaining FFM (r 5 20.5 to 20.8, P , 0.001). Conclusion: Significant relationships were noted between spasticity and variables of body composition and metabolic profile in persons with chronic motor complete SCI, suggesting that spasticity may play a role in the defense against deterioration in these variables years after injury. The exact mechanism is yet to be determined.

This large prospective cohort study indicates the risk of sustaining a cerebral concussion is nearly six times greater for individuals with a history of concussion than for individuals with no such history.