Body composition assessment in adults with spinal cord injury

Sarcopenia (muscle wasting) and fat accumulation due to paralysis significantly impair activities of daily living, community mobility, cardiopulmonary health, bowel and bladder function, skin integrity, and spasticity in persons with spinal cord injury (SCI) and can contribute to morbidities associated with obesity including atherosclerosis, diabetes, dyslipidemia, hypertension, chronic pain, depression, and societal isolation. Body composition assessment is used to distinguish fat from muscle, bone, and organs in a given individual. Typical methods of body composition assessment used for most populations underestimate body fat in SCI and are relatively insensitive to changes that may occur from exercise and nutritional interventions. Current body composition assessment techniques and limitations of those techniques for application to persons with SCI are discussed. Recommendations are made for future investigations to validate clinical assessment tools with the 4-compartment (gold standard) model of body composition assessment.