Рossibilities of comprehensive correction of malnutrition in spinal cord injured patients

BACKGROUND: Medical rehabilitation of spinal cord injured patients is an important medical and social problem associated with the high level of disability in this patient category.

AIM: This study aims to improve the efficiency of medical rehabilitation of spinal cord injured patients based on a set of measures of nutritional support and raising the exercise tolerance.

MATERIALS AND METHODS: A total of 78 patients in the intermediate recovery period of spinal cord injury were monitored, and their nutritional status was evaluated in the dynamics. In the first (main) group, a complex correction of the nutritional status with additional use of high protein hypercaloric mixtures for enteral nutrition was performed before and after hand cycling. In the second (control) group, the rehabilitation techniques were performed on the generally accepted basis.

RESULTS: As a result of the complex correction, the proportion of patients with mild and moderate malnutrition was significantly lower in the first (main) group than that in the second (control) group (p=0.05). Peak oxygen consumption increased in the first group of patients with mild malnutrition on 34.1% (p=0.019) and with moderate malnutrition on 23.6% (p=0.02) compared to that in the control group. All spinal cord injured patients of the first (main) group were found to have improved their motor and social activity according to the FIM scale compared to that in the control group (p <0.001).

CONCLUSIONS: Combining adequate nutritional support and proper handcycling significantly contributes to reducing malnutrition in patients with spinal cord injury (p=0.05). Tolerance to physical exercises during the complex correction of malnutrition significantly increased (p <0.01) as well as the motor and social activities and, therefore, the quality of life (p <0.0001).