MRI analysis and clinical significance of lower extremity muscle cross-sectional area after spinal cord injury

Shortly after spinal cord injury（SCI）, the musculoskeletal system undergoes detrimental changes in size and composition, predominantly below the level of injury. The loss of muscle size and strength, along with increased immobility, predisposes persons with SCI to rapid and severe loss in bone mineral density and other health related consequences. Previous studies have highlighted the significance of measuring thigh muscle cross-sectional area, however, measuring the size and composition of muscles of the lower leg may provide insights on how to decrease the risk of various comorbidities. The purpose of the current review was to summarize the methodological approach to manually trace and measure the muscles of the lower leg in individuals with SCI, using magnetic resonance imaging. We also intend to highlight the significance of analyzing lower leg muscle cross-sectional area and its relationship to musculoskeletal and vascular systems in persons with SCI.

Leisure-time physical activity,anthropometrics,and body composition as predictors of quality of life domains after spinal cord injury:an exploratory cross-sectional study

The objective of the current work was to examine the relationships between quality of life(QOL)domains in persons with spinal cord injury(SCI)and their levels of weekly leisure-time physical activity(LTPA),anthropometric variables,and body composition variables.This exploratory cross-sectional study consisted of baseline data collected as part of a randomized clinical trial at a VA Medical Center and SCI center.A convenience sample of 36 community-dwelling persons with SCI participated in the current study.Outcome measures included the World Health Organization Quality of Life Short Form(WHOQOL-BREF),Leisure-Time Physical Activity Questionnaire for People with Spinal Cord Injury(LTPAQ-SCI),anthropomorphic measures(waist,hip,and abdominal circumference),and dual-energy x-ray absorptiometry(DXA)to quantify regional and total body composition.Multiple regression models suggested that engagement in LTPA accounted for 35.7%of the variance in physical health QOL,33.5%in psychological QOL,14.2%in social relationships QOL,and 38.2%in environmental QOL.Anthropometric measures accounted for 11.3%,3.1%,12.0%,and 6.7%of the variance in these QOL indices,respectively,and DXA indices accounted for 18.7%,17.5%,27.4%,and 21.9%.Within these models,the number of minutes of heavy LTPA per day uniquely predicted physical health QOL,the number of mild LTPA days per week uniquely predicted psychological QOL,and the amount of mild LTPA per day uniquely predicted environmental QOL.Bivariate analyses also suggested that android and trunk fat,as well as supine waist and abdominal circumferences,were positively associated with social relationships QOL.Encouraging individuals with SCI to engage in LTPA may robustly enhance multiple aspects of QOL while reducing the risk for cardiovascular and metabolic morbidities associated with SCI.Moreover,this may lead to a further understanding of how QOL may impact longitudinal intervention trials.The study protocol and procedures were reviewed and approved by the McGuire VA Research Institutional Review Board(IRB#02152,approval date August 9,2015;IRB#02375,approval date May 2,2018).