By Maureen McArthur

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About 230,000 Americans have spinal cord injuries, and about 10,000 new cases occur each year. People between the ages of 16 and 30 account for more than half of all spinal cord injuries.

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Extensive research has demonstrated benefits of aerobic exercise for the able-bodied population. However, because of the unique physiology of spinal cord-injured (SCI) patients, few researchers have pursued the development of a structured exercise program for them.

"Acute rehabilitation hospitals do a good job working with SCI patients to a certain point," said David Gater, M.D., Ph.D., assistant professor, Department of Physical Medicine and Rehabilitation, UK College of Medicine and clinician in outpatient rehabilitative services in the UK Chandler Medical Center and the Veterans Affairs Medical Center in Lexington. "But optimal health maintenance is sacrificed in the following years."

Following the acute phase of rehabilitation, the greatest risk for mortality after a spinal cord injury is heart disease. Few clinicians prescribe an exercise regimen for SCI patients because the parameters have not been defined, and inappropriate exercise may have no benefit and may even be dangerous, Gater said.

Gater is enrolling both physically active and sedentary SCI patients in the study.

Gater measures the subjects’ basal metabolic rate, oxygen consumption, lipid profiles, glucose tolerance and body composition at the beginning of the study. The patients then complete an aerobic exercise program for 30 minutes three times each week over 10 weeks. Gater will repeat all measurements at the end of the study.

The measurements are taken at the General Clinical Research Center, which is located at the UK Chandler Medical Center. Exercises are completed at UK at the Exercise Physiology Laboratory in the Seaton Center and the VAMC in Lexington.

Along with investigating the possible benefits of improving patients’ lipid profiles and glucose tolerance, Gater also is studying what kind of exercise is most helpful for maintaining independence and quality of life.

"What we may think of as a minor annoyance may mean loss of independence to them," Gater said. "SCI individuals are at a much higher risk for musculoskeletal disorders, such as a torn rotator cuff or carpal-tunnel syndrome, which can severely limit their ability to get around. From a functional and metabolic standpoint, we want to find out whether endurance or strength training is more beneficial."

Because of limits in autonomic responses to exercise, such as heart or respiratory rate, it is more likely that SCI patients could get hurt during exercise than able-bodied people could.

"The exercise prescription for SCI people should be like a medical prescription – a specific exercise performed at a set intensity for a specific duration with a defined goal in mind," Gater said. "This study is a first step toward that prescription."