Reconditioning exercises pursued by persons with incomplete SCI have shown to reverse the decline in function imposed by the paralysis (Jacobs et al 2001).  Nutrition-related modifications that optimize physical performance for individuals with SCI have not been studied extensively compared to that of individuals without disability.

Table: Nutrient Intake on Ambulation Performance

Discussion

Dietary, pharmacologic and nutrient modifications that may optimize physical performance for individuals with SCI have not been extensively studied.  In the able-bodied population an effective nutrient supplementation combination to hasten recovery from intense activity and to improve performance in subsequent bouts of exercise is whey protein and carbohydrate (Ivy, 2001; Ivy 1998).  Nash et al (2007) investigated the effect of protein and carbohydrate intake on ambulation in three persons with incomplete SCI (C5 – T4).  The subjects walked to fatigue on 5 consecutive days; upon fatigue, participants consumed 48 grams of whey plus 1 gram per kilogram of body weight of carbohydrate.  The process was repeated following a weekend of rest.  Following a 2-week wash-out period the process was repeated using 48 grams of soy supplement.  Oxygen consumption, carbon dioxide production, respiratory exchange ratio, distance and time of walk and calculated calorie expenditure were measured.  The authors concluded that the combination of whey protein plus carbohydrate supplement ingestion following fatiguing ambulation improved subsequent ambulation by increasing distance, time to fatigue and caloric expenditure compared to soy supplement consumption.  

Conclusion

• There is level 2 evidence based on one RCT cross-over trial (Nash et al., 2007) that the consumption of a whey protein plus carbohydrate supplement following fatiguing ambulation improves subsequent ambulation by increasing distance, time to fatigue and caloric expenditure in persons with incomplete SCI. 

• The consumption of a whey protein plus carbohydrate supplement following fatiguing ambulation improves subsequent ambulation by increasing distance, time to fatigue and caloric expenditure in persons with incomplete SCI.