Body Composition in Disabilities of Central Nervous System

Bone And Soft Tissue Changes In Patients With Spinal Cord Injury And Multiple Sclerosis

“…4 Given that most SCIs occur before achievement of peak bone mass, and the rate of bone resorption and formation is reduced during the chronic stage of the disability, particularly below the level of injury, low values of BMD and increased risk of osteoporosis and fractures in these patients are not surprising. 3 The relative difference in energy expenditure between MS patients and able-bodied individuals is probably lower than the relative difference in physical activity, because patients with MS have a higher energy expenditure of physical activity. 5 Reduced physical activity and probably reduced energy expenditure in MS need to be accompanied by a reduction in energy intake otherwise body fat will increase.…”

“…1,2 These changes have a great implication for the health of the disabled individuals. 3 Carbohydrate intolerance, insulin resistance, lipid abnormalities, bone loss and osteoporosis, and coronary artery heart disease occur prematurely and at a higher prevalence. There is a need to quantify the changes in bone, muscle and fat tissue to prevent the related diseases and their complications.…”

“…There is a need to quantify the changes in bone, muscle and fat tissue to prevent the related diseases and their complications. [1][2][3] The main issue with SCI and MS is that the onset of disability leads to acute (in SCI patients) or progressive (in MS patients) immobilization associated with loss of lean mass (LM) and bone mineral density (BMD) versus a gain in fat mass (FM). Both SCI and MS share different pathophysiology, location and evolution, but they may lead to similar residual immobility and reduced function for the patients.…”

“…Patients with complete lesions have greater bone loss compared to those with incomplete lesions. 3 Additional important differences between SCI and MS are the evolution of the lesion in progressive MS compared to a stable neurological status in complete paraplegia SCI, the type of injury with neurological level of injury in complete or incomplete tetraplegia or paraplegia compared to upper motor neuron pyramidal lesion in MS, and the different treatment options between the two groups of patients. Moreover, there are differences in the degree of spasticity (flaccid in MS compared to spastic paralysis in SCI patients), which is very likely to play a regulatory role in maintaining BMD.…”

“…2 Additionally, patients with MS and SCI often experience depression that further limits mobility. 3 The dependency on mobility aids and the frequent periods of immobilization after multiple operative procedures contribute to the hypoactivity status of such subjects. It could be assumed that, under these conditions, body composition may be significantly compromised in favour of fat tissue.…”