Comparison of methods to assess energy expenditure and physical activity in people with spinal cord injury

Abstract

Objective: To compare different methods of assessing energy expenditure (EE) and physical activity (PA) in people with spinal cord injury (SCI) under community-dwelling conditions. Methods: A reference standard encompassing the doubly labelled water (DLW) technique, heart rate monitoring (FLEX-HR), a multi-sensor armband (SenseWear Armband (SWA)), and two PA recall questionnaires were employed in 14 people with SCI to estimate EE and leisure-time PA. Results: Mean total daily energy expenditure (TDEE) assessed by DLW, FLEX-HR, and SWA were 9817 ± 2491 kJ/day, 8498 ± 1516 kJ/day, and 11414 ± 3242 kJ/day, respectively. Physical activity energy expenditure (PAEE) quantified by DLW was 2841 ± 1626 kJ/day, 2935 ± 1732 kJ/day estimated from FLEX-HR, and 2773 ± 2966 kJ/day derived from SWA. After converting the PA recall questionnaire data to EE in kJ/day, PAEE for the Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI) was 2339 ± 1171 kJ/day and for Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) 749 ± 1026 kJ/day. DLW-quantified PAEE was moderately associated with PARA-SCI (R 2 = 0.62, P < 0.05), but not with the other estimates of PAEE (R 2 ranged between 0.13 and 0.30, P > 0.05). Conclusion: Our findings revealed that the PARA-SCI recall questionnaire was the best estimate of PAEE compared to the reference standard DLW approach. Although the between-method variability for SWA, FLEX-HR, and PASIPD-derived PAEE was small, there was a weak association between these methods and the criterion DLW technique. The best estimate of DLW-quantified TDEE was by FLEX-HR. SWA significantly overestimated TDEE in this population.

Psychosocial factors associated with physical activity in ambulatory and manual wheelchair users with spinal cord injury: a mixed-methods study

“…On a related note, with a larger sample of ambulators, some of the nonsignificant pathways may have been significant. We also acknowledge the limitations of using a self-report measure of LTPA; however, we retain confidence in our findings given that the PARA-SCI is superior to the other widely available measures of energy expenditure in persons with SCI (other questionnaire, heart rate monitoring, arm-band accelerometer) when referenced against the gold-standard of doubly labeled water [20]. Finally, the interview participants were all middle-aged or older and had some experience, past or present, with LTPA.…”

“…The PARA-SCI has demonstrated good construct validity and reliability as a measure of physical activity among people with SCI [20,21,19]. As per the PARA-SCI protocol, during a structured interview, participants recalled all physical activities they performed over the previous 3 days that required physical exertion.…”

A description and estimate of very low-intensity activity and inactive awake time in community-dwelling adults with chronic spinal cord injury

“…Research using the PARA-SCI suggests that these are activities with a metabolic equivalent (MET) value of 1.5 or greater. 21 Participants were also asked to report the times they woke up and went to sleep each day. Average daily awake time was created by taking a sum of daily awake time and dividing by three.…”

“…The PARA-SCI has demonstrated reliability and validity for use in people with SCI, establishing validity through comparison with both doubly labelled water and indirect calorimetry. 19,21,22 Demographic characteristics. Participants reported their age, sex, education, ethnicity and marital status at baseline.…”

Treino de natação para pessoas sedentárias com lesão medular e concentração de colesterol-HDL

“…Todavia, os indivíduos acometidos frequentemente adotam estilo de vida sedentário, com reduções significativas no nível de atividade física cotidiana, que repercute negativamente em vários aspectos da saúde, qualidade e expectativa de vida 2 . A limitação motora decorrente da lesão na medula espinhal promove redução na massa magra e diminuições na taxa metabóli-ca basal que podem chegar perto de 30% 3 .…”