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Exercise to mitigate cardiometabolic disorders after spinal cord injury
Mark S Nash1, Gary J Farkas2, Eduard Tiozzo2
1Department of Neurological Surgery, The University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Physical Medicine & Rehabilitation, The University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Physical Therapy, The University of Miami Miller School of Medicine, Miami, FL 33136, USA; The Miami Project to Cure Paralysis, The University of Miami Miller School of Medicine, Miami, FL 33136, USA.
Insights
Cardiometabolic disorder (CMD) is a growing global health risk, particularly prevalent in individuals with spinal cord injuries (SCI). Exercise and nutrition are recommended as key interventions to manage CMD after SCI.
Area of Science:
- Cardiology
- Endocrinology
- Neurology
- Public Health
Background:
- Cardiometabolic disorder (CMD) is a cluster of cardiovascular, endocrine, and inflammatory risks, posing a significant health threat comparable to diagnosed coronary artery disease or type 2 diabetes.
- CMD is typically diagnosed when three or more of five key risk factors are present: obesity, insulin resistance, hypertension, hypertriglyceridemia, and low HDL cholesterol.
- The prevalence of CMD is increasing globally, with individuals with spinal cord injuries (SCI) experiencing over 50% higher rates compared to the non-disabled population.
Purpose of the Study:
- To define cardiometabolic disorder (CMD) in the context of spinal cord injuries (SCI).
- To explore the underlying pathophysiology of CMD following SCI.
- To present evidence supporting exercise as a primary countermeasure for CMD health risks in individuals with SCI.
Main Methods:
- Literature review and synthesis of existing evidence on CMD and SCI.
- Analysis of diagnostic criteria for CMD.
- Examination of pathophysiological mechanisms linking SCI to CMD.
- Evaluation of studies investigating exercise interventions for CMD in SCI populations.
Main Results:
- Individuals with SCI exhibit a high prevalence of CMD, often exceeding 50% compared to non-disabled cohorts.
- Established risk factors for CMD are frequently observed in the SCI population.
- Evidence supports lifestyle interventions, particularly exercise, as crucial for managing CMD in SCI.
Conclusions:
- CMD represents a critical and escalating health concern for individuals living with SCI.
- Early and consistent lifestyle interventions, emphasizing exercise and nutrition, are essential for mitigating CMD risks post-SCI.
- Further research and clinical guidelines are necessary to address CMD management in the SCI population.
Abstract:
The cardiometabolic disorder (CMD) is a syndrome caused by coalescing of cardiovascular, endocrine, pro-thrombotic, and inflammatory health risks. Together, these risks confer a hazard as health-threatening as coronary artery disease or type2 diabetes, whether an individual has a diagnosis of coronary disease or diabetes, or not. CMD is most often defined by three or more of five clinically assessed risk components, notably obesity, insulin resistance, hypertension, hypertriglyceridemia, and depressed high-density lipoprotein cholesterol. Evidence currently suggests that worldwide CMD is expanding at a pandemic rate, and it is known that people living with spinal cord injuries (SCI) qualify for the diagnosis at more than 50% of the prevalence of a non-disabled cohort. A recent evidence-based guideline warned of the current state of CMD following SCI and recommended early lifestyle intervention incorporating exercise and prudent nutrition as a first-line disease countermeasure. This monograph will define the CMD following SCI, explore its underlying pathophysiology, and provide evidence that recommends exercise for CMD health hazards after SCI.
