Body mass index changes over 3 years and effect of obesity on community mobility for persons with chronic spinal cord injury

Objective: To identify the prevalence of obesity in persons with chronic spinal cord injury (SCI), determine change in body mass index (BMI) over time, and identify impact of obesity on community mobility. Design: Prospective three year longitudinal study. Setting: Outpatient clinic of rehabilitation center. Participants: Convenience sample of 222 persons with paraplegia between 2-20 years post SCI. Outcome Measures: BMI at baseline and three years; community mobility (daily wheelchair propulsion distance and velocity, average number of daily transfers and depression raises). Results: Participants were 34.1 (27.3, 40.3) years of age and median duration of SCI was 8.7 (3.2, 15.1) years. The SCI adjusted BMI classification identified 44% of participants as obese. BMI increased over time with 13% moving into a higher weight category. Median change in BMI was 0.46 (−0.92, 1.50) kg/m 2 (z = −2.684, P = 0.007), and increased at a rate of 0.15 kg/m 2 /yr. Average BMI was negatively correlated with daily wheelchair propulsion distance (r = −0.179, P = 0.009), however there was no significant relationship with velocity, number of daily transfers or depression raises. Conclusion: The majority of participants with chronic SCI were overweight (23%) or obese (44%) and BMI increased by 0.46 kg/m 2 over three years. Those with higher BMIs pushed their wheelchairs shorter distances, but other mobility measures were not impacted by body weight. Continued mobility activities with increasing body weight can increase risk for shoulder injury. Identifying persons who are obese allows for directed and timely health and mobility intervention.