Nutrient Supplementation Post Ambulation in Persons With Incomplete Spinal Cord Injuries: A Randomized, Double-Blinded, Placebo-Controlled Case Series

Nash MS, Meltzer NM, Martins SC, Burns PA, Lindley SD, Field-Fote EC. Nutrient supplementation post ambulation in persons with incomplete spinal cord injuries: a randomized, double-blinded, placebo-controlled case series.

Objective

To examine effects of protein-carbohydrate intake on ambulation performance in persons with incomplete spinal cord injury (SCI).

Design

Double-blinded treatment with washout and placebo crossover.

Setting

Academic medical center.

Participants

Three subjects aged 34 to 43 years with incomplete SCI at C5-T4.

Interventions

Subjects walked to fatigue on 5 consecutive days. On fatigue, participants consumed 48g of vanilla-flavored whey and 1g/kg of body weight of carbohydrate (CH2O). Weekend rest followed, and the process was repeated. A 2-week washout was interposed and the process repeated using 48g of vanilla-flavored soy.

Main Outcome Measures

Oxygen consumed (V̇o2; in L/min), carbon dioxide evolved (V̇co2), respiratory exchange ratio (RER: V̇co2/V̇o2), time (in minutes), and distance walked (in meters) were recorded. Caloric expenditure was computed as V̇o2 by time by 21kJ/L (5kcal/L) of oxygen consumed. Data were averaged across the final 2 ambulation sessions for each testing condition.

Results

Despite slow ambulation velocities (range, .11–.34m/s), RERs near or above unity reflected reliance on CH2O fuel substrates. Average ambulation time to fatigue was 17.8% longer; distance walked 37.9% longer, and energy expenditure 12.2% greater with the whey and CH2O supplement than with the soy drink.

Conclusions

Whey and CH2O ingestion after fatiguing ambulation enhanced ensuing ambulation by increasing ambulation distance, time, and caloric expenditure in persons with incomplete SCI.