Nutrient supplementation post ambulation in persons with incomplete spinal cord injuries: a randomized, double-blinded, placebo-controlled case series.

Abstract

To examine effects of protein-carbohydrate intake on ambulation performance in persons with incomplete spinal cord injury (SCI). Double-blinded treatment with washout and placebo crossover. Academic medical center. Three subjects aged 34 to 43 years with incomplete SCI at C5-T4. 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 (CH(2)O). Weekend rest followed, and the process was repeated. A 2-week washout was interposed and the process repeated using 48g of vanilla-flavored soy. Oxygen consumed (Vo(2); in L/min), carbon dioxide evolved (Vco(2)), respiratory exchange ratio (RER: Vco(2)/Vo(2)), time (in minutes), and distance walked (in meters) were recorded. Caloric expenditure was computed as Vo(2) by time by 21kJ/L (5kcal/L) of oxygen consumed. Data were averaged across the final 2 ambulation sessions for each testing condition. Despite slow ambulation velocities (range, .11-.34m/s), RERs near or above unity reflected reliance on CH(2)O 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 CH(2)O supplement than with the soy drink. Whey and CH(2)O ingestion after fatiguing ambulation enhanced ensuing ambulation by increasing ambulation distance, time, and caloric expenditure in persons with incomplete SCI.