Original Article

Spinal Cord advance online publication 4 April 2017; doi: 10.1038/sc.2017.27

Energy expenditure in people with motor-complete paraplegia

T Holmlund1,2, E Ekblom-Bak3, E Franzén4,5, C Hultling1, L Nilsson Wikmar4 and K Wahman1,2

  1. 1Department of Neurobiology, Care Sciences and Society, Division of Neurodegeneration, Neurorehabilitation Section, Karolinska Institutet, Stockholm, Sweden
  2. 2Rehab Station Stockholm/Spinalis R&D Unit, Stockholm, Sweden
  3. 3Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, Stockholm, Sweden
  4. 4Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden
  5. 5Department of Physical Therapy, Karolinska University Hospital, Stockholm, Sweden

Correspondence: T Holmlund, Rehab Station Stockholm, Frösundaviks allé 13, 169 89 Solna, Sweden. E-mail: tobias.holmlund@ki.se

Received 26 May 2016; Revised 27 January 2017; Accepted 9 February 2017
Advance online publication 4 April 2017



Study design:


The present descriptive clinical and laboratory study is cross-sectional in design.



The primary aim is to describe and compare resting energy expenditure (REE) and energy expenditure (EE) during different standardized sedentary, non-exercise and exercise activities in people with motor-complete paraplegia (Th7 to Th12.). A secondary aim was to compare men and women.



Thirty-eight adults (10 women) with SCI, T7-T12 AIS A-B, were recruited. All the data were collected through indirect calorimetry. REE was measured in supine for 30min after 8h of overnight fasting. Activity energy expenditure (AEE) for activities was measured for seven minutes during sedentary, non-exercise physical activity (NEPA) and exercise activities.



AEE increased four to eight times when engaging in NEPA compared to that in sedentary activities. Men had significantly higher resting oxygen uptake compared to women, 0.19 vs 0.15lmin−1 (P=0.005), REE per 24h, 1286 vs 1030kcal (P=0.003) and EE during weight-bearing activities. However, these became nonsignificant after adjustment for body weight and speed of movement, with a mean resting oxygen uptake of 2.47ml O2 per kgmin−1 for the whole group (women 2.43 and men 2.57ml O2kg−1min−1, P=0.49).



NEPA increases AEE up to eight times compared to sedentary activities. Gender differences in oxygen uptake during both rest and weight-bearing activities were diminished after adjustment for body weight. The mean resting oxygen uptake for the whole group was 2.47ml O2kg−1min−1. These results highlight the importance, especially of NEPA, for increasing total daily EE in the target population.