Composição corporal de indivíduos com lesão medular cervical: influência do exercício físico e comparação de métodos

Abstract

Objective: To compare total and regional body composition and fat mass distribution in physically active and non active men with cervical spinal cord injury (SCI) and its relationship with C-reactive protein (CRP) levels. Also, to identify a bioelectric impedance (BIA) protocol that provides results of percentage of total fat mass (FM) in agreement with those obtained by the reference method - dual energy X-ray absorptiometry (DXA). Methods: All participants presented spinal cord injury between C5-C7 and were classified as active (n=15) or non-active (n=10). Individuals having a minimum of 150 minutes of physical activity per week, practiced three times a week or more, for at least three months were considered active. The determination of total and regional body composition (arms, legs and trunk) was performed by DXA. CRP levels were performed by immunoturbidimetry. BIA protocols tested were indicated to: a) individuals with SCI (KOCINA & HEYWARD, 1997), b) a group including elderly (GRAY et al, 1989), c) validated protocol for Brazilian elderly (DEY et al, 2003). The statistical analysis included ANCOVA to compare body weight, body composition and CRP between groups, and partial correlation to identify the association of physical exercise with MG and of CRP with physical exercise and trunk FM. All analyses were controlled for duration of injury (DOI). The comparison between DXA and BIA protocols was performed by one-way ANOVA and Dunnet post hoc test. The Bland-Altman analysis was performed to verify the agreement between the methods. Conclusion: physical exercise is important to the maintenance of lower levels of FM in whole body and to avoid trunk FM accumulation in cervical SCI subjects. Moreover, the best body composition and FM distribution found in the active group possibly lead to lower serum CRP levels. Taken together, these adaptations may contribute to decrease the risk of cardiometabolic disease in cervical SCI subjects. An elderly BIA protocol appeared to be useful for body composition assessment of cervical SCI subjects possibly due to the similarities in body composition adaptations typical of aging and SCI.