- The Body Mass Index (BMI) is a measure of physical health that compares a person’s weight with their height
- Individuals with SCI with a BMI less than 25 are normal, those with a BMI of 25-29 are overweight, those with a BMI of 30-39 are obese, and those with a BMI of 40 or over are extremely obese
Clinical Considerations
Though no norms have been established in SCI, it will be important to adjust and consider a person’s BMI score in accordance with their SCI.
ICF Domain
Body Structures ▶ Digestive, Metabolic and Endocrine
Administration
- A person’s BMI can be self-determined by referencing their height and weight in a BMI chart
- Administered time is less than 5 minutes
Number of Items
N/A
Equipment
N/A
Scoring
The patient’s mass in kilograms is divided by the square of the patient’s height in metres to give the BMI score (e.g., 80kg/1.8m2 = 24.69).
Languages
N/A
Training Required
None
Availability
Full BMI Chart is available here: https://www.nhlbi.nih.gov/health/educational/lose_wt/BMI/bmi_tbl.pdf
# of studies reporting psychometric properties: 4
Interpretability
MCID: not established
SEM: not established
MDC: not established
Typical Values
- Male:
- Mean BMI (SD) = 26.21 (5.9)
- BMI categorization:
Underweight = 5.8%
Normal weight = 36.6%
Overweight = 35.1%
Obese = 21.0%
- Female:
- Mean BMI (SD) = 24.46 (6.7)
- BMI categorization:
Underweight = 11.0%
Normal weight = 51.2%
Overweight = 22.6%
Obese = 12.8%
(Alschuler et al. 2012; n=488 with SCI, 324 males, 164 females; mean age: 55.84 years; AIS A-D)
Reliability
Not established in SCI
Validity
- High Correlation of BMI with abdominal fat (kg): r=0.92
- High Correlation of BMI with total fat (kg): r=0.91
- High Correlation of BMI with abdominal fat (%): r=0.80
- High Correlation of BMI with total fat (%): r=0.77
- Low Correlation of BMI with CVD risk (Framingham risk score): r=0.29
(Cragg et al. 2015; n=27, 70% males; 30% females; mean age (SD): 40 (11) years; ASIA A-D; injury level: 59% cervical, 41% thoracic; mean time since injury (SD): 14 (10) years)
- Moderate Correlation of BMI with bioelectrical impedance analysis (another way to estimate obesity): r=0.51
(Eriks-Hoogland et al. 2011; n=23; 100% males; mean age (SD): 43.3 (12) years; 22 ASIA and 1 ASIA B; mean time since injury (SD): 14.6 (13.3) years)
Responsiveness
No values were reported for the responsiveness of the BMI for the SCI population.
Floor/Ceiling Effect
No values were reported for the presence of floor/ceiling effects in the BMI for the SCI population.
Reviewers
Dr. William Miller, Dr. Carlos L. Cano-Herrera, Frances Fan
Date Last Updated
31 December 2024
Alschuler KN, Gibbons LE, Rosenberg DE, et al. Body mass index and waist circumference in persons aging with muscular dystrophy, multiple sclerosis, post-polio syndrome, and spinal cord injury. Disabil Health J. 2012;5(3):177-84.
http://www.ncbi.nlm.nih.gov/pubmed/22726858
Buchholz AC, Bugaresti JM. A review of body mass index and waist circumference as markers of obesity and coronary heart disease risk in persons with chronic spinal cord injury. Spinal Cord. 2005;43(9):513-8.
http://www.ncbi.nlm.nih.gov/pubmed/15824757
Cragg JJ, Ravensbergen HJ, Borisoff JF, Claydon VE. Optimal scaling of weight and waist circumference to height for adiposity and cardiovascular disease risk in individuals with spinal cord injury. Spinal Cord. 2015;53(1):64-8.
http://www.ncbi.nlm.nih.gov/pubmed/25266694
Eriks-hoogland I, Hilfiker R, Baumberger M, Balk S, Stucki G, Perret C. Clinical assessment of obesity in persons with spinal cord injury: validity of waist circumference, body mass index, and anthropometric index. J Spinal Cord Med. 2011;34(4):416-22.
http://www.ncbi.nlm.nih.gov/pubmed/21903016
Flank P, Wahman K, Levi R, Fahlström M. Prevalence of risk factors for cardiovascular disease stratified by body mass index categories in patients with wheelchair-dependent paraplegia after spinal cord injury. J Rehabil Med. 2012;44(5):440-3.
http://www.ncbi.nlm.nih.gov/pubmed/22549653
Gupta N, White KT, Sandford PR. Body mass index in spinal cord injury — a retrospective study. Spinal Cord. 2006;44(2):92-4.
http://www.ncbi.nlm.nih.gov/pubmed/16030513
Ravensbergen HR, Lear SA, Claydon VE. Waist circumference is the best index for obesity-related cardiovascular disease risk in individuals with spinal cord injury. J Neurotrauma. 2014;31(3):292-300.
http://www.ncbi.nlm.nih.gov/pubmed/24070685
Shin JW, Kim T, Lee B-S, Kim O. Factors Affecting Metabolic Syndrome in Individuals With Chronic Spinal Cord Injury. Ann Rehabil Med. 2022;46(1):24-32
https://pubmed.ncbi.nlm.nih.gov/35272437/
Willems A, Paulson TA, Keil M, Brooke-wavell K, Goosey-tolfrey VL. Dual-Energy X-Ray Absorptiometry, Skinfold Thickness, and Waist Circumference for Assessing Body Composition in Ambulant and Non-Ambulant Wheelchair Games Players. Front Physiol. 2015;6:356.
http://www.ncbi.nlm.nih.gov/pubmed/26640442
Zwierzchowska A, Głowacz M, Batko-szwaczka A, et al. The Body Mass Index and Waist Circumference as Predictors Of Body Composition in Post CSCI Wheelchair Rugby Players (Preliminary Investigations). J Hum Kinet. 2014;43:191-8.
http://www.ncbi.nlm.nih.gov/pubmed/25713660