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A systematic review of weight management strategies in persons with spinal cord injury

Why the research is needed? 

Following a spinal cord injury (SCI) individuals are susceptible to changes in body composition, such as an increased adiposity. This leads to an increased risk of obesity and related comorbidities. However, the best practise for weight gain prevention in the acute stage of SCI and weight loss in the chronic stage of SCI are not well established. Furthermore, attitudes toward weight management interventions, from both patients and healthcare practitioners, have not been systematically appraised.

This review is needed because:

  • We don’t know what the best weight management approaches are in SCI
  • We don’t know the totality of the current evidence base
  • We have weight management clinics for people with SCI within the NHS that don’t appear to be evidence based
  • We need to create a platform of evidence to show the gaps for new research
  • We must address the needs of this unique population. Weight management is difficult in non-disability communities, and given the differences in physiological differences (e.g., low muscle mass, low resting metabolic rate) its even harder in people with a SCI.

What is already known about the subject? 

An increasing number of studies that have investigated weight management strategies have been published in the last decade. However, since this work there has been some really important steps forward in obesity therapy e.g. in the non-disabled population with the licencing of new obesity pharmacotherapy (semaglutide) and emergence of low-energy diets that have shown to be effective at supporting weight loss and diabetes remission. 

Who we are working with? 

  • Specialist Dietitian for Spinal Cord Injuries at Princess Royal Spinal Injuries Centre, Northern Hospital, Sheffield
  • Physiotherapist at Linden Lodge Neuro-Rehabilitation Unit, Nottingham
  • Multidisciplinary Association for Spinal Cord Injury Professions (MASCIP)
  • Matt Hampson Foundation (Get Busy Living Centre)
  • Wheelchair manufacturers

How are patients and the public involved? 

We are working closely with the needs of end-users and partners within the Peter Harrison Centre for Disability Sport (PHC) network and within the East Midlands community. 

What we will do? 

We will run initial focus groups including academics, clinicians and people with lived SCI experience to establish the focus of the systematic review. Thereafter, the research team will conduct the formal literature search and categorise the available literature based on the weight management strategy studied. As co-production is a key feature of the systematic review and the dissemination of its findings, we will engage with end-users throughout the project.

What the benefits will be? 

The impact will be to improve practice and knowledge on existing weight management strategies which fail to consider the diverse characteristics of people with SCI.

When the findings will be available? 

The findings will be available at the end of 2023. 

How we are planning for implementation? 

The clinical experience and community contacts present within the research team assures that an impactful co-production team can be convened. The team will review and discuss the findings of the systematic review and help to create dissemination material.


Professor Vicky Tolfrey,


Cover image credits: Loughborough University