Impact of vitamin D on mobilization, pulmonary function tests, grip strength and functionality in patients with spinal cord injury: A cross-sectional study

Fatmanur Aybala Koçak; Belma Füsun Köseoğlu; Serap Tomruk Sütbeyaz

doi:10.28982/josam.689130

Authors

Fatmanur Aybala Koçak https://orcid.org/0000-0002-2224-3324
Belma Füsun Köseoğlu https://orcid.org/0000-0002-3463-009X
Serap Tomruk Sütbeyaz https://orcid.org/0000-0002-1992-7178

DOI:

https://doi.org/10.28982/josam.689130

Keywords:

Paraplegia, 25-hydroxy-vitamin D, Orthostatic hypotension, Lung function, Functional independence measure

Abstract

Aim: Since vitamin D deficiency is a growing problem worldwide, insufficient levels of vitamin D were reported in patients with spinal cord injury (SCI). It was stated that levels of vitamin D may be an indirect indicator of functional status in patients with SCI. The aim of this study was to investigate the relationship between vitamin D levels and mobilization, functionality, grip strength, and pulmonary function test parameters in patients with subacute SCI.
Methods: Fifty-eight patients with subacute motor complete thoracic (T) and lumbar SCI injuries [46 males, 12 females; mean age 32.0 (11.2) years] were included. The time to complete the verticalization program on the tilt table without any orthostatic symptoms was considered as the ‘time of mobilization.’ Grip strength (GS) was measured using a dynamometer, pulmonary function test (PFT) parameters were measured using a spirometer, and functional status was measured using the Functional Independence Measure (FIM). For determining the levels of vitamin D, 25-hydroxy-vitamin D [25(OH)D] was measured and levels below 20 ng/mL were considered as deficiency. The patients were divided into two groups according to 25(OH)D levels, <20 ng/mL and ≥20 ng/mL. The demographic features, mobilization, PFT, GS, and FIM scores were compared according to the levels of 25(OH)D. The patients were divided into two other groups according to neurologic levels: levels between T6-10 and levels T11 and below, and then intragroup comparisons according to the levels of 25(OH)D were performed.
Results: The mean 25(OH)D level of the patients was found as 19.8 (8.3) ng/mL. When all patients were evaluated, time of mobilization was longer and FIM scores were lower in the 25(OH)D deficient group than in the other group (P<0.001 and P=0.038, respectively). When patients were evaluated separately according to their neurologic levels, time of mobilization was longer in the 25(OH)D deficient group, both in patients with a lesion level between T6-10 and the lesion levels T11 and below (P<0.001 and P=0.009, respectively). There was no statistically significant difference between the groups in terms of other clinical evaluations according to the neurologic levels of the patients.
Conclusion: Among the patients with SCI, time of mobilization of patients with vitamin D deficiency was longer than those of patients with non-deficient vitamin D levels, regardless of the neurologic level. Although the results of this study showed no statistically significant difference there may also be a relationship between vitamin D levels and pulmonary functions, GS, and FIM scores.

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