It can be challenging to measure and maintain healthy nutrition in patients who have sustained acute Spinal Cord Injury (SCI), but it is critical to maintaining patients' ongoing health and wellbeing. Researchers are improving the practices that surround this process by testing the accuracy of existing measurement techniques.
It is not uncommon for SCI to lead directly to malnutrition and loss of body mass, as the body responds first to the initial stress of an injury, and then to a sudden decrease in activity.
Malnutrition is a significant issue as it has been associated with several important aspects of physical health after SCI (including skin integrity, immune function and body composition). It can also impact upon health in the chronic stage as well as later stages of recovery after SCI.
To date, dietitians have measured nutritional needs of SCI patients using the Schofield Equation. There is concern, however, that this method is a crude measure, not distinguishing between changes in lean muscle mass and body fat.
Professor Mary Galea from The University of Melbourne's Faculty of Medicine Dentistry and Health Sciences led a research team to test Schofield Equation against other options, including:
- The Doubly Labelled Water (DLW) technique
- Dual Energy X-ray Absorptiometry (DEXA)
- Bioelectrical Impedance Spectroscopy (BIS)
The ultimate objective of the project was to improve the health of SCI patients by ensuring accurate and timely measurement of their nutritional requirements.
This team released a report in October 2015.
The report confirms that current clinically used equations (such as the Schofield Equation) yield inaccurate estimates and should not be used. The other options all proved to be more accurate, including the most practical option of BIS.
BIS has already been adopted in clinical practice by the Victorian Spinal Cord Service at Austin Health. This may lead to significant improvements in health and wellbeing outcomes for individuals with SCI.