- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03111030
ProACTIVE SCI Physical Activity Intervention
ProACTIVE SCI Physical Activity Coaching Intervention
Study Overview
Detailed Description
A randomized, wait-list controlled trial will be used to compare the effects of tailored PA coaching sessions versus no coaching on PA behaviour, psychosocial factors, and health outcomes. Eligible individuals will be randomly assigned (1:1) to either the experimental (PA coaching sessions) or wait-list control condition. Matched randomization based on baseline physical activity levels will be used. The randomization sequence will be generated by a research assistant independent of the trial.
Day 1 testing measures include vascular measures (arterial pulse wave velocity, arterial structure; 30 minutes), cardiac structure and function measures (30 minutes), a peak oxygen uptake test (60 minutes), for a total duration of 2 hours. Participants will be given an accelerometer to wear for the 6-day monitoring period (6.1.2) after which they will return for Day 2 testing.
Day 2 testing measures include administration of the LTPAQ (5 minutes), administration of the demographics and Health Action Process Approach model questionnaire (25 minutes), and a measurement of energy expenditure at different sub-maximal wheeling speeds to calibrate MVPA cut-points (30 minutes) and at baseline, the first PA coaching session will be administered (60 minutes) whereas at post-test a semi-structured interview will be administered (60 minutes). Total duration of day 2 testing will be 2 hours. The intervention protocol is described below. During the intervention, physical activity will be sampled at two time points; accelerometer and PARA SCI data will be taken during week 4 and week 7.
INTERVENTION
Intervention Protocol:
Experimental participants will receive weekly PA coaching sessions. Each session will be 10-15 minutes in duration and delivered either face to face, over Skype, or when the former modes are unavailable, over the phone. Additionally, supplemental resources may be emailed to the participants based on need throughout the intervention.
Participants' motivation to exercise will first be determined according to stages of the HAPA model. Those who identify as pre-intenders (no intention to exercise) will receive intervention strategies that focus on changing motivation to be physically active. Those identified as intenders (willing to exercise but have not started) will focus on providing resources and behavioural strategies to commence physical activity. Lastly, those identified as actors (already exercising) will receive intervention strategies that help participants maintain or improve PA behaviour.
For those in the intender or actor stage, the intervention aims to promote the international SCI PA guidelines to promote fitness (at least 20 minutes of moderate vigorous aerobic activity twice/week and strength training twice/week). For those exceeding the fitness guidelines, the international SCI PA guidelines to promote health are promoted (at least 30 minutes of moderate to vigorous aerobic activity three times/week and strength training twice/week). However, these aims will be modified based on the individual's baseline PA. During the first visit, participants' baseline PA levels will be reviewed and an appropriate PA goal to achieve in the following month will be formed. Ultimately, the goal is the decision of the participant.
Following goal setting, barriers to participating in PA will be identified. The interventionist will select intervention strategies based on the identified barriers. A pre-formed chart of corresponding intervention strategies (e.g. use of behaviour change techniques, referral to facilities or peers, suggesting at-home exercises) was developed to aid this pairing process (Appendix A). These intervention strategies are accompanied by a comprehensive toolkit based from the HAPA model (Appendix B). In brief, the toolkit advises on three key strategies for promoting PA to people with SCI: i) education, ii) referral, iii) tailored PA prescription.
Remaining weekly coaching sessions will review participants' progress and barriers to discuss new goals and strategies as outlined above.
Control Participants:
Control participants will complete baseline and post-testing only. Following completion of post-test measures they will be administered the same PA coaching session as the intervention group, with post-test measures being repeated upon intervention completion.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
British Columbia
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Kelowna, British Columbia, Canada, V1V 1V7
- University of British Columbia Okanagan
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Vancouver, British Columbia, Canada, V5Z 1M9
- International Collaboration On Repair Discoveries
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Individuals must be competent to give informed consent,
- be able to propel an arm ergometer.
Exclusion Criteria:
- History and/or symptoms of CVD or cardiopulmonary problems/disease.
- Major trauma or surgery within the last 6 months.
- Active Stage 3 or 4 pressure ulcer (based on the National Pressure Ulcer Advisory Panel classification)
- Recent (within 1 year) history of lower-extremity or non-union fracture
- Any unstable medical/psychiatric condition or substance abuse disorder that is likely to affect their ability to complete this study.
- Individuals with active medical issues such as pressure sores, urinary tract infections, hypertension, or heart disorders.
- Any cognitive dysfunction or language barrier that would prevent subjects from following English instructions.
- Subjects may be excluded at the discretion of the principal investigator due to other, unforeseen, safety issues.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: SUPPORTIVE_CARE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: NONE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
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EXPERIMENTAL: ProacTive SCI
Individualized physical activity coaching sessions
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Participants will receive weekly physical activity coaching sessions. Each session will be 10-15 minutes, delivered either face to face, over Skype, or over the phone. Additional resources may be emailed to participants based on need throughout the intervention (for example, a goal, list of places to exercise, contact information to reach mentoring services). A typical session may include:
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NO_INTERVENTION: Wait-list control
Standard care, receiving physical activity coaching sessions after completing post-testing
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Physical Activity: Leisure Time Physical Activity Questionnaire for People With SCI (LTPAQ)
Time Frame: Baseline, week 4, week 7, week 10, 6 month follow up
|
Participants will be asked to complete a questionnaire, guided by the co-investigator (Jasmin Ma), that asks the participant to recall in the last 7 days how many days and for how long leisure time physical activity was performed.
The recall assessment will take approximately 5 minutes to complete.
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Baseline, week 4, week 7, week 10, 6 month follow up
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Change in Total Accelerometer Count as a Measure of Change in Physical Activity: 6-day Physical Activity Monitoring Period
Time Frame: Baseline, week 4, week 7, week 10
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Participants will be fitted with a wrist-based tri-axial accelerometer to be worn 24 hours a day for 6 days in order to determine intensity and amount of PA.
They will keep a detailed PA diary recording all leisure time PA performed during the day.
The primary outcome will be total vector magnitude (VM) accelerometer counts from a tri-axial wrist-worn accelerometer (GT9X, ActiGraph LLC, FL).
During the intervention, the accelerometer will be picked up and dropped off to the participant's home to decrease burden.
Text or email reminders (i.e.
"Please don't forget to wear your accelerometer today") will be used to promote adherence to accelerometer wear.
|
Baseline, week 4, week 7, week 10
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Health Action Process Approach Model Measure
Time Frame: Baseline, 9 weeks from intervention start (week 10)
|
This survey will examine psychological factors that may affect PA participation.
The survey will be recorded either electronically or with pen and paper depending on the respondent's preference.
Survey will take approximately 25 minutes to complete, and will assess constructs related to exercise such as perceived risks, self- efficacy, planning, and social support.
The demographics questionnaire will also be administered with this measure.
All items will be assessed on a 7-point Likert scale ranging from 1 = "strongly disagree" to 7 = "strongly agree".
Higher scores indicate a better outcome.
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Baseline, 9 weeks from intervention start (week 10)
|
Number of Participants Participating in Qualitative Interviews
Time Frame: 9 weeks from intervention start (week 10)
|
A semi-structured interview will be conducted at the end of the intervention to understand what components were and were not effective.
Data will not be recorded.
This feedback will be used to improve future iterations of the intervention.
There is no associated scale with this measurement.
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9 weeks from intervention start (week 10)
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Change in Pulse Wave Velocity
Time Frame: Baseline, 9 weeks from intervention start (week 10)
|
aPWV (cm/s) is calculated by dividing the distance between measurement sites, by the pulse transit time.
Distance between the carotid and femoral arteries will be measured using measuring tape along the surface of the body, held parallel to the testing table.
The pulse transit is determined from the arterial blood pressure waves, which are collected at each arterial site.
A pen-like device (model SPT-301; Millar Instruments Inc., Houston, TX) will be applied to the carotid and femoral arterial sites using a light pressure to obtain arterial pressure waves.
Heart rate will be recorded using a single-lead (lead I) electrocardiogram (ECG) (model ML 123, ADInstruments Inc., Colorado Springs, CO).
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Baseline, 9 weeks from intervention start (week 10)
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Change in Arterial Structure: Wall Thickness
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Common carotid arterial images will be collected using B-mode ultrasound (INFO) for 10 cardiac cycles.
Images will be analyzed using internal ultrasound software to determine lumen diameter and intima-media thickness.
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Baseline, 9 weeks from intervention start (week 10)
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Change in End Systolic Volume
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
|
Baseline, 9 weeks from intervention start (week 10)
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Change in End Diastolic Volume
Time Frame: Baseline, 9 weeks from intervention start (week 10)
|
Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
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Baseline, 9 weeks from intervention start (week 10)
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Change in Intraventricular Septum Diameter
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
|
Baseline, 9 weeks from intervention start (week 10)
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Change in Ventricular Internal Diameter
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
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Baseline, 9 weeks from intervention start (week 10)
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Change in Systolic Function
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
LV stroke volume will be used to measure change in systolic function.
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Baseline, 9 weeks from intervention start (week 10)
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Change in Ejection Fraction
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
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Baseline, 9 weeks from intervention start (week 10)
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Change in Cardiac Output
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
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Baseline, 9 weeks from intervention start (week 10)
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Change in Fractional Shortening
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
Longitudinal strain will be used to measure change in fractional shortening.
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Baseline, 9 weeks from intervention start (week 10)
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Change in Diastolic Function
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Cardiac image will be collected non-invasively using Doppler ultrasound (Vivid q, GE Healthcare, Buckinghamshire, UK).
Image will be collected and stored on the ultrasound for offline analysis.
E'/A' (ratio between early diastolic septal tissue velocity and late diastolic septal tissue velocity) will be used to measure change in diastolic function.
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Baseline, 9 weeks from intervention start (week 10)
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Aerobic Fitness Evaluation: Peak Oxygen Uptake Test (VO2peak)
Time Frame: Baseline, 9 weeks from intervention start (week 10)
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Participants will perform a graded arm ergometer test on an electronically braked arm ergometer. For participants with tetraplegia who have limited handgrip function, gloves will be used to secure hands to the ergometer handles. Participants will be instructed to maintain a cycling rate of 50 revolutions per minute (rpm) for the duration of the test. After an initial warm-up at 0W, power output will be increased each minute at a rate of 2-5 W/min for participants with tetraplegia, or 10 W/min for participants with paraplegia, until volitional exhaustion (i.e. dropping below 30 rpm). Oxygen consumption will be recorded on a breath-by-breath basis for the duration of the test and reported as rolling 30-second averages sampled at 5-second intervals as per consensus recommendations. All outcome data are reported here: https://doi.org/10.1007/s40279-019-01118-5 |
Baseline, 9 weeks from intervention start (week 10)
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Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Kathleen Martin Ginis, PhD, University of British Columbia- Okanagan
Publications and helpful links
General Publications
- Dinwoodie M, Hoekstra F, Stelzer S, Ma JK, Martin Ginis KA. A dynamic analysis of physical activity barriers experienced by adults with spinal cord injury. Spinal Cord Ser Cases. 2022 Mar 29;8(1):37. doi: 10.1038/s41394-022-00504-y.
- Hoekstra F, Collins D, Dinwoodie M, Ma JK, Martin Ginis KA. Measuring behavior change technique delivery and receipt in physical activity behavioral interventions. Rehabil Psychol. 2022 May;67(2):128-138. doi: 10.1037/rep0000440. Epub 2022 Mar 17.
- Ma JK, West CR, Martin Ginis KA. The Effects of a Patient and Provider Co-Developed, Behavioral Physical Activity Intervention on Physical Activity, Psychosocial Predictors, and Fitness in Individuals with Spinal Cord Injury: A Randomized Controlled Trial. Sports Med. 2019 Jul;49(7):1117-1131. doi: 10.1007/s40279-019-01118-5.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- H17-00559
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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