Article

Persons with spinal cord injury (SCI) have heightened risk for cardiovascular
disease (CVD). Multidisciplinary risk reduction programs using case management
models have been effective in reducing CVD risk in nondisabled persons, but
little is known regarding the effects of such programs in SCI. Twenty-six persons
with SCI underwent a pilot 2 yr risk intervention program including frequent
telephone contact by a case manager and in-person visits by a dietitian, physical
therapist, and exercise physiologist. At 6 mo intervals, measurements were made
of dietary intake, glucose and lipids, physical activity patterns, and exercise
capacity. Of the 26 participants, 10 remained in the program for the full 2 yr;
medical issues unrelated to the program were the major reasons for dropping out.
Significant improvements were observed in weight, plasma insulin, homeostatic
model assessment insulin resistance, and total cholesterol/high-density
lipoprotein ratio, although these changes were not consistent across visits. No
differences in estimates of physical activity patterns were demonstrated, nor
were differences in dietary macronutrient intake observed. Thus, modest changes
in some CVD risk markers can be achieved by a multidisciplinary risk reduction
program in SCI. Such programs present more challenges than in ambulatory persons,
and more intensive risk intervention may be required to appreciably reduce CVD
risk in SCI.

Langue : ANGLAIS