SCI predispose to glucose intolerance and insulin resistance, presumably due to changes in body composition and skeletal muscle dysfunction, placing SCI individuals at greater risk for diabetes and coronary artery disease. In the able-bodied, marked improvements in glucose tolerance have been reported in response to aerobic exercise, with variable changes in insulin sensitivity. Resistance training has also improved glucose tolerance, and to a greater extent, insulin sensitivity in the able-bodied. Exercise responses in SCI have not been examined as extensively as they have in the general population, and yet this population has significantly more to gain than the able-bodied population by improving metabolic and functional abilities. The proposed hypothesis is that aerobic exercise, resistance training and/or a combination of aerobic exercise and resistance training will improve body composition and glucose tolerance, but only exercise which involves resistance training, and subsequent increases in muscle mass, will significantly improve insulin sensitivity in individuals with SCI. Twenty individuals with motor complete T6-L2 SCI will be recruited each year to participate in one of the following exercise protocols. Subjects will be randomly assigned to control or aerobic (Trial 1), resistance (Trial 2), and combined (Trial 3) exercise groups. Glucose tolerance, insulin sensitivity and body fat will be determined before and after each of the exercise interventions. If glucose intolerance and subsequently diabetes mellitus can be prevented in individuals with SCI by utilizing appropriately dosed exercise, significant savings in health care dollars and improved quality of life could be realized.
|Clasey, Jody L; Gater Jr, David R (2005) A comparison of hydrostatic weighing and air displacement plethysmography in adults with spinal cord injury. Arch Phys Med Rehabil 86:2106-13|
|Clasey, Jody L; Janowiak, Adrienne L; Gater, David R (2004) Relationship between regional bone density measurements and the time since injury in adults with spinal cord injuries. Arch Phys Med Rehabil 85:59-64|