Association Between Sarcopenic Obesity and Activities of Daily Living in Individuals with Spinal Cord Injury

Background/Objectives: Sarcopenic obesity adversely affects physical function and activities of daily living (ADL) in older individuals and patients undergoing rehabilitation. This condition is also common in individuals with spinal cord injury (SCI); however, its relationship with ADL in this group remains unclear. Hence, this study examined the association between sarcopenic obesity and ADL in individuals with SCI. Methods: This retrospective cross-sectional study identified sarcopenia using the low skeletal muscle mass index (SMI) and Asian Working Group for Sarcopenia reference values. Obesity was defined as a body fat percentage (%BF) exceeding 25% in men and 35% in women. Sarcopenic obesity was identified when both the sarcopenia and obesity criteria were met. The primary outcome, ADL, was measured using the Functional Independence Measure (FIM). Multiple linear regression models were used to analyze the associations among the SMI, %BF, and FIM scores, after adjusting for age, sex, lesion level, injury severity, comorbidities, and injury duration. Results: Of 82 participants (median age: 63.5 years; 18.3% women), 62.2% had sarcopenic obesity. Participants with sarcopenic obesity (54 vs. 69 points, p = 0.006) had significantly lower FIM motor scores than those without this condition. Multiple linear regression analysis revealed that SMI (β = 0.416, p < 0.001) and %BF (β = -0.325, p = 0.009) were independently associated with the FIM motor scores. Conclusions: Decreased SMI and increased %BF in patients with SCI were independently associated with decreased ADL independence. Routine body composition assessments are necessary for early detection and intervention in this population.