Modification of the Diabetes Prevention Program Lifestyle Intervention in Persons with Spinal Cord Injury: Efficacy for Reducing Major Cardiometabolic Risks, Increased Fitness, and Improved Health-Related Quality of Life

J Spine Res Surg, 2024 · DOI: 10.26502/fjsrs0070 · Published: January 1, 2024

Spinal Cord Injury Cardiovascular Science

Simple Explanation

This study explores how a modified Diabetes Prevention Program (DPP) lifestyle intervention impacts individuals with spinal cord injury (SCI). People with SCI often face higher risks of heart and metabolic diseases. The intervention included exercise, a Mediterranean-style diet, and behavioral support. The study measured various health outcomes like body mass, glucose regulation, fitness levels, and overall quality of life. The results showed significant improvements in body mass, glucose control, cholesterol levels, fitness, and quality of life for the participants. These improvements suggest that this type of intervention can be beneficial for people with SCI.

Study Duration

1 Year

Participants

20 individuals with SCI (aged 28-60) with neurologic injuries at levels C4-T10 and ASIA scale grades A-D

Evidence Level

Prospective intervention cohort study

Key Findings

1
Significant reduction in body mass and BMI by 7.5%, indicating effective weight management through the Therapeutic Lifestyle Intervention (TLI).
2
Substantial improvements in glucose regulation and insulin sensitivity, demonstrating a positive impact on diabetes risk factors.
3
The Physical and Mental Composite Scores of the SF36 improved by 22.8% and 30.5%, respectively, showcasing enhanced overall well-being.

Research Summary

This study assessed the effectiveness of a DPP-adapted TLI for SCI on mitigating obesity and related CMS risks, improving health-related fitness measures and improving health-related quality of life measures. The TLI resulted in significant whole-body mass and fat mass reductions after TLI, as well as significant improvements in markers of glucose metabolism, lipids, cardiorespiratory fitness, dynamic strength, and both physical and mental composite self- assessment scores associated with health-related quality of life (HRQoL). The findings suggest the TLI is effective in reducing CMS risks and co-morbid disorders, and should be considered as a first-line rehabilitation strategy to off-set secondary cardiometabolic health complications in SCI.

Practical Implications

Clinical Practice

The TLI can be integrated into rehabilitation programs for individuals with SCI to address cardiometabolic risks and improve overall health outcomes.

Public Health

Implementing community-based TLI programs can promote healthier lifestyles and reduce the burden of cardiometabolic diseases in the SCI population.

Future Research

Further studies should focus on long-term sustainability and cost-effectiveness of TLI in SCI, and identify strategies for enhancing adherence and individualizing the intervention.

Study Limitations

1
Adherence to the TLI during the minimally supervised 6-month self-care extension phase
2
Transition from a controlled research environment to “less structured” community deployment carries inherent challenges
3
Future studies should target larger samples to confirm these findings and provide statistical power to better evaluate significance for all outcome measures.

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