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Effects of Nutrient Intake on Ambulation Performance

Reconditioning exercises pursued by persons with incomplete SCI have shown to reverse the decline in function imposed by the paralysis (Jacobs et al. 2001). Nutrition-related modifications that optimize physical performance for individuals with SCI have not been studied extensively compared to that of individuals without disability.

Table 14 Nutrient Intake on Ambulation Performance

Author Year

Country
PEDro Score
Research Design
Sample Size

MethodsOutcomes
 

 

Nash et al. 2007

USA

PEDro=5

Cross-over RCT

N=3

 

 

 

Population: Mean age=38.7 yr; Gender: males=2, females=1; Level of injury: paraplegia=1, tetraplegia=2; Severity of injury: AISA C=2, D=1; Time since injury=11.3 yr.

Intervention: On a 24m oval track, subjects walked to fatigue consecutively over 5 days. In trial 1, once fatigued, subjects consumed 48 g of vanilla whey and 1g/kg patient body weight of carbohydrate (CH0). Control subjects received a soy placebo solution. Subjects rested over the weekend then repeated the procedure. After a two week washout period, individuals crossed over to receive the alternate treatment.

Outcome Measures: Ambulation time, distance walked, and energy expenditure.

1.     Regardless of testing order, the average ambulation time was 17.8% longer (32.0 min versus 27.1 min), distance walked was 37.9% longer (470 m versus 341 m), and energy expenditure to fatigue was 12.2% greater (731k J [174kcal] versus 651 kJ [155kcal]) with the whey and CHO supplement than placebo.

Discussion

Dietary, pharmacologic and nutrient modifications that may optimize physical performance for individuals with SCI have not been extensively studied. In the non-SCI population an effective nutrient supplementation combination to hasten recovery from intense activity and to improve performance in subsequent bouts of exercise is whey protein and carbohydrate (Ivy 1998; Ivy 2001). Nash et al. (2007) investigated the effect of protein and carbohydrate intake on ambulation in three persons with incomplete SCI (C5-T4). The subjects walked to fatigue on five consecutive days; upon fatigue, participants consumed 48 grams of whey plus 1 gram per kilogram of body weight of carbohydrate. The process was repeated following a weekend of rest. Following a 2-week wash-out period the process was repeated using 48 grams of soy supplement. The authors concluded that the combination of whey protein plus carbohydrate supplement ingestion following fatiguing ambulation improved subsequent ambulation by increasing distance, time to fatigue and caloric expenditure compared to soy supplement consumption.

Conclusion

There is level 2 evidence (from one RCT crossover trial; Nash et al. 2007) that the consumption of a whey protein plus carbohydrate supplement following fatiguing ambulation improves subsequent ambulation by increasing distance, time to fatigue and caloric expenditure in persons with incomplete SCI.

  • The consumption of a whey protein plus carbohydrate supplement following fatiguing ambulation improves subsequent ambulation by increasing distance, time to fatigue and caloric expenditure in persons with incomplete SCI.