Independent Association of Vitamin D With Physical Function in People With Chronic Spinal Cord Injury

Barbonetti, Arcangelo; Sperandio, Alessandra; Micillo, A.; D’Andrea, Settimio; Pacca, F.; Felzani, Giorgio; Francavilla, Sandro; Francavilla, Felice

doi:10.1016/j.apmr.2016.01.002

Cited by 26 publications

(32 citation statements)

References 58 publications

(69 reference statements)

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“…Nevertheless, in light of the potential decline of serum 25OHD during rehabilitation as a result of compromised sun exposure and reduced vitamin D intake, our study underscores that vitamin D repletion protocols prevent further deterioration of vitamin D status during the subacute phase. Consistent with other studies [6,22,23], level of motor impairment did not affect serum 25OHD in our study. Baseline and post-intervention 25OHD levels did not differ between AIS A + B and C + D individuals.…”

Section: Discussionsupporting

confidence: 93%

Effectiveness of two vitamin D3 repletion protocols on the vitamin D status of adults with a recent spinal cord injury undergoing inpatient rehabilitation: a prospective case series

Mailhot

Lamarche

Gagnon

2018

Spinal Cord Ser Cases

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Study design: Prospective case series Objectives: To assess the effectiveness and safety of two vitamin D 3 repletion protocols given to individuals with spinal cord injury (SCI). Setting: Publicly-funded intensive inpatient rehabilitation center, Montreal, Canada. Methods: Thirty adults with recent SCI complete or incomplete sensorimotor impairments were recruited upon admission from designated regional SCI trauma centers. Participants with serum 25OHD ≤ 30 nmol/L were given 10,000 IU of weekly and 1000 IU of daily vitamin D 3 for 36.8 ± 11.9 days (higher dose: HD). Subjects with serum 25OHD > 30 nmol/L received 1000 IU of daily vitamin D 3 for 38.2 ± 11.6 days (lower dose: LD). Outcomes were changes in 25OHD levels from baseline to the end of the study period and safety outcomes. Thresholds for vitamin D deficiency, insufficiency and sufficiency were: 25OHD levels ≤30 nmol/L, 30-74 nmol/L, and ≥75 nmol/L. Results: At baseline, 34 and 66% of participants had serum 25OHD < 30 and >30 nmol/L. Both protocols induced a rise in serum 25OHD with a greater increase in the HD vs. LD regimen (31.4 [95% CI: 16.7, 46.0] vs. 11.7 nmol/L [95% CI: 2.2, 21.2]). None of the participants given the HD remained vitamin D deficient, but only one achieved vitamin D sufficiency. Nearly all individuals on the LD regimen remained vitamin D insufficient with only two reaching vitamin D sufficiency. No adverse effects were observed over the course of the supplementation. Conclusions: Although 1000 IU of daily vitamin D 3 alone or in combination with weekly 10,000 IU for an average of 37.6 days increased serum 25OHD, they were unsuccessful in improving the impaired vitamin D status during inpatient rehabilitation of individuals with a recent SCI.

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Section: Discussionsupporting

confidence: 93%

Effectiveness of two vitamin D3 repletion protocols on the vitamin D status of adults with a recent spinal cord injury undergoing inpatient rehabilitation: a prospective case series

Mailhot

Lamarche

Gagnon

2018

Spinal Cord Ser Cases

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“…These results support prior studies that demonstrated high rates (24%-94%) of VDD in inpatient rehabilitation populations. [6][7][8][11][12][13][14][15] It is important to note that previous studies used varying definitions of VDD and VDI, which may contribute to the broad range of VDD prevalence observed.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, 83% of inpatients in subacute rehabilitation were found to have VDD . In patients with chronic spinal cord injury, associations have been found between insufficient vitamin D and depression, lower functional independence, poorer engagement in leisure time activity, and lower free testosterone levels in men …”

Section: Introductionmentioning

confidence: 99%

“…Inadequate levels of vitamin D in patients undergoing inpatient rehabilitation have been confirmed in previous studies. VDD has been found in 34%-93% of patients with spinal cord injuries, [6][7][8] 25% of patients with traumatic brain injuries, 7 72%-94% of patients with orthopedic injuries, [9][10][11] and 70%-94% of patients undergoing general rehabilitation with mixed diagnoses. 10,12 In addition, 83% of inpatients in subacute rehabilitation were found to have VDD.…”

Section: Introductionmentioning

confidence: 99%

“…10,12 In addition, 83% of inpatients in subacute rehabilitation were found to have VDD. 13 In patients with chronic spinal cord injury, associations have been found between insufficient vitamin D and depression, 14 lower functional independence, poorer engagement in leisure time activity, 8 and lower free testosterone levels in men. 15 Patients undergoing inpatient rehabilitation may be more adversely affected by VDD given their significant comorbidities combined with the possibly devastating consequences of impaired physical and cognitive function.…”

Section: Introductionmentioning

confidence: 99%

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Intervention for Increasing Vitamin D Supplementation in a Deficient Rehabilitation Population: Outcomes of a Quality Improvement Initiative

Krull

Abramoff

Jerome

et al. 2019

PM&R

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Background Vitamin D deficiency (VDD) is highly prevalent and increases the risk of osteoporosis, falls, and fractures. Patients in acute inpatient rehabilitation have several risk factors for VDD, the adverse effects of which may hinder long‐term functional gain. Objective To evaluate the prevalence of and risk factors for VDD in patients admitted to acute inpatient rehabilitation and to evaluate the efficacy of a standardized vitamin D screening and supplementation protocol. Design Prospective cohort study as part of a quality improvement initiative. Setting An academic, freestanding acute inpatient rehabilitation hospital. Participants Patients consecutively admitted over a 4‐month period between November 2014 and February 2015 (n=128 pre‐intervention and n=129 post‐intervention). Intervention Universal screening of vitamin D level on admission followed by utilization of a standard supplementation protocol. Main Outcome Measures Vitamin D insufficiency (VDI) and VDD prevalence along with screening, and supplementation rates. Results Preintervention, 10.2% of patients were screened for VDD, with 23.1% VDI and 46.2% VDD. Postintervention, 89.9% were screened, with 31.9% VDI and 47.4% VDD. 6.3% of all patients were supplemented on vitamin D preintervention compared to 53.5% postintervention. In multivariate analyses, the odds of VDD was significantly associated with African American race (OR 7.30, 95% CI, 1.56‐34.20, P = .12) and age younger than 65 (OR 13.62 95% CI, 2.51‐73.83, P = .002). Diagnoses in the “other neurologic” category were associated with decreased odds of VDD (OR 0.01, 95% CI, 0.001‐0.193, P = .002). Conclusions Given the high prevalence of VDD in an acute inpatient rehabilitation hospital, a routine screening and standardized supplementation protocol may improve quality of care. Level of Evidence III

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Increased Bone Fracture After SCI: Can Exercise Reduce Risk?

Draghici

Shefelbine

2016

The Physiology of Exercise in Spinal Cord Injury

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Independent Association of Vitamin D With Physical Function in People With Chronic Spinal Cord Injury

Cited by 26 publications

References 58 publications

Effectiveness of two vitamin D3 repletion protocols on the vitamin D status of adults with a recent spinal cord injury undergoing inpatient rehabilitation: a prospective case series

Effectiveness of two vitamin D3 repletion protocols on the vitamin D status of adults with a recent spinal cord injury undergoing inpatient rehabilitation: a prospective case series

Intervention for Increasing Vitamin D Supplementation in a Deficient Rehabilitation Population: Outcomes of a Quality Improvement Initiative

Increased Bone Fracture After SCI: Can Exercise Reduce Risk?

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