Management of obesity after spinal cord injury: a systematic review.
J Spinal Cord Med
; 40(6): 783-794, 2017 11.
Article
in En
| MEDLINE
| ID: mdl-28929907
ABSTRACT
CONTEXT Individuals with chronic spinal cord injury (SCI) are susceptible to central and visceral obesity and it's metabolic consequences; consensus based guidelines for obesity management after SCI have not yet been stablished. OBJECTIVES:
To identify and compare effective means of obesity management among SCI individuals.METHODS:
This systematic review included English and non-English articles, published prior to April 2017 found in the PubMed/Medline, Embase, CINAHL Psychinfo and Cochrane databases. Studies evaluating any obesity management strategy, alone or in combination, including diet therapy, voluntary and involuntary exercise such as neuro-muscular electric stimulation (NMES), pharmacotherapy, and surgery, among individuals with chronic SCI were included. Outcomes of interest were reductions in waist circumference, body weight (BW), body mass index (BMI) and total fat mass (TFM) and increases in total lean body mass (TLBM) from baseline. From 3,553 retrieved titles and abstracts, 34 articles underwent full text review and 23 articles were selected for data abstraction. Articles describing weight loss due to inflammation, cancer or B12 deficiency were excluded. The Downs and Black reported poor to moderate quality of the studies.RESULTS:
Bariatric surgery produced the greatest permanent weight reduction and BMI correction followed by combinations of physical exercise and diet therapy. Generally, NMES and pharmacotherapy improved TLBM and reduced TFM but not weight.CONCLUSIONS:
The greatest weight reduction and BMI correction was produced by bariatric surgery, followed by a combination of physical exercise and diet therapy. NMES and pharmacologic treatment did not reduce weight or TFM but increased in TLBM.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Spinal Cord Injuries
/
Obesity
Type of study:
Etiology_studies
/
Guideline
/
Systematic_reviews
Limits:
Humans
Language:
En
Journal:
J Spinal Cord Med
Journal subject:
NEUROLOGIA
/
REABILITACAO
Year:
2017
Document type:
Article
Affiliation country:
Canada