Spinal cord injuries

Nutrition recommendations currently used in sport for those with an impairment are primarily based upon data from able-bodied athletes (as outlined in Chapter 3), but these are almost certainly not directly transferable to athletes with a spinal cord injury (SCI). As an example, the smaller working muscle mass used by an athlete with SCI during wheelchair propulsion will lead to lower energy requirements during training than those of able-bodied (AB) athletes (Glaser 1985) in equivalent sports (Price 2010). Furthermore, there may be considerable muscle atrophy in the lower limbs, leading to a lower resting metabolic rate and, in turn, a further reduction in daily energy expenditure (EE). To prevent unwanted weight gain, energy intake must be correspondingly reduced. Consequently, a number of intriguing questions centre on the physiology of individuals with SCI particularly in relation to EE, energy requirements and performance, all of which will be discussed in this chapter. For the purposes of this chapter, spinal cord injuries include spina bifida and traumatic and nontraumatic spinal cord lesions.