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Energy Costs of Spasticity in Spinal Cord Injury: A Pilot Investigation

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City:   Richmond
State:   Virginia
Zip Code:   23249
Conditions:   Basal Energy Expenditure - Spasticity
Purpose:   The purpose of this study is to determine if there is a relationship between spasticity and relative changes in Basal Energy Expenditure in persons with spinal cord injury.
Study Summary:   Obesity is at epidemic proportions in the population with spinal cord injury (SCI), and is likely the mediator of the metabolic syndrome in this special population. Recent literature reviews have suggested that obesity is present in > 67% of persons with SCI. Additionally, recent studies have demonstrated the causal relationship between adipose tissue accumulation and vascular inflammation, dyslipidemia, insulin resistance / glucose intolerance, hypertension and thromboemboli. Obesity in SCI occurs because of acute and ongoing positive energy balance, i.e., greater caloric intake than energy expenditure. Total Daily Energy Expenditure (TDEE) in SCI is reduced primarily because of muscular atrophy and diminished muscular contraction; pharmacological treatment of spasticity possibly reduces energy expenditure (EE) even further, but has not been evaluated to date. TDEE is comprised of three components: Basal Energy Expenditure (BEE), Thermic Effect of Activity (TEA) and Thermic Effect of Food (TEF). Of the three, BEE contributes the greatest amount (65-75% TDEE) and is the most sensitive to changes in spasticity. Dampening spasticity has been reported to increase weight gain and necessitate reduced caloric intake in a child with spastic quadriplegia. Similarly, athetosis in patients with cerebral palsy increased resting metabolic rate (RMR) as compared to control subjects with no athetotic movements. Although several studies have reported energy requirements for persons with neurodevelopmental disabilities, and even SCI, however, none have attempted to measure the metabolic effect of spasticity.
Criteria:   Inclusion Criteria: - C1-T10 SCI at least 1 year post injury - Spasticity in the legs - Veteran Exclusion Criteria: - Recent increase in spasticity - Botox within 6 months - Phenol within 2 years - Prior surgery for spasticity
NCT ID:   NCT00572845
Primary Contact:   Principal Investigator
David R Gater, MD, PhD
McGuire VA Medical Center

Ajit B Pai, MD
Phone: 804-675-6741
Email: apai@vcu.edu
Backup Contact:   N/A
Location Contact:   Richmond, Virginia 23249
United States

Ajit B Pai, MD
Phone: 804-675-6741
Email: apai@vcu.edu

Site Status: Recruiting

Data Source:   ClinicalTrials.gov
Date Processed:   May 24, 2013
Modifications to this listing:   Only selected fields are shown, please use the link below to view all information about this clinical trial.
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