Trajectories in the Course of Body Mass Index After Spinal Cord Injury

ObjectiveTo identify different trajectories of the course of body mass index (BMI) after spinal cord injury (SCI) and to study whether other cardiovascular risk factors (blood pressure, lipid profile) follow the same trajectories.DesignMulticenter prospective cohort study with measurements at the start of active rehabilitation, after 3 months, at discharge, and 1 and 5 years after discharge.SettingRehabilitation centers.ParticipantsPersons with a recent SCI (N=204).InterventionsNot applicable.Main Outcome MeasureBMI trajectories.ResultsThree BMI trajectories were identified: (1) a favorable stable BMI during and after rehabilitation (±22–23kg/m2) (54%); (2) a higher but stable BMI during inpatient rehabilitation (±24kg/m2) and an increase after discharge (up to 29kg/m2) (38%); and (3) an increase in BMI during inpatient rehabilitation (from ±23 up to 28kg/m2) and leveling off after discharge (8%). Profile analyses showed that an unfavorable change in BMI was not accompanied by clear unfavorable changes in blood pressure or lipid levels.ConclusionsBMI in people with SCI follows distinct trajectories. Monitoring body mass, food intake, and daily physical activity during and especially after inpatient SCI rehabilitation is important to prevent obesity and related cardiovascular risk factors.