Protocol for Rapid Onset of Mobilization in Patients With Traumatic Spinal Cord Injury III (PROMPT-SCI III) Trial (PROMPT-SCI III)
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
GOALS: This longitudinal cohort study will investigate the clinical benefits of early acute exercise therapy after mild spinal cord injury (SCI).
Primary hypothesis: Recovering independent walking 1 year after a mild SCI is more likely with early acute exercise therapy, in comparison with a historical cohort not exposed to early acute exercise therapy. An increase in the percentage of individuals recovering independent walking in the community from 35% to 55% will be considered as a clinically meaningful increase.
Secondary hypothesis: Acute complications, neurological recovery, functional independence, quality of life and care pathway are improved with early acute exercise therapy.
METHODS: For this 5-year study, 107 participants with mild acute traumatic SCI will be recruited. Participants will perform daily 30-minute sessions of seated cycling throughout acute care, starting within 2 days of their surgery to decompress the spinal cord. The immediate response to cycling will be monitored from physiological (hemodynamic and respiratory) and electrophysiological (electromyography and H-reflex testing in lower extremities) assessments. Independent walking in the community (primary outcome) is defined by the ability to walk 100 meters outdoors without technical aids or only with leg orthosis. Secondary outcomes include all complications occurring during acute care (particularly early spasticity, pneumonia, urinary tract infection and pressure injury) and the care pathway (discharge destination and length of stay), as well as neurological recovery, functional independence and quality of life 1 year after the SCI. Outcomes will be compared to a control cohort of patients with mild SCI who did not receive exercise therapy during acute care, and the association with electrophysiological measures will be assessed.
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Jean-Marc Mac-Thiong, MD, PhD
- Telefonnummer: 1+514-338-2222
- E-mail: jean-marc.mac-thiong@umontreal.ca
Undersøgelse Kontakt Backup
- Navn: Andreane Richard-Denis Richard-Denis, MD, MSc
- Telefonnummer: 1+514-338-2222
- E-mail: andreane.rdenis@umontreal.ca
Studiesteder
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Quebec
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Montreal, Quebec, Canada, h4j1c5
- Hôpital du Sacré-Cœur de Montréal
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Kontakt:
- Lara Chawa
- Telefonnummer: 1+514-338-2222
- E-mail: lara.chawa.cnmtl@ssss.gouv.qc.ca
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Ledende efterforsker:
- Jean-Marc Mac-Thiong, MD, PhD
-
Ledende efterforsker:
- Andreane Richard-Denis, MD, MSc
-
-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- adults 18 years or older with non-penetrating traumatic SCI
- SCI severity AIS grade D (motor function preserved with most key muscles able to move against gravity)
- NLI between C0 and L2; and spine surgery performed within 48 hours of SCI
Exclusion Criteria:
- intubated and mechanically ventilated
- conditions interfering with patient safety or ability to undergo cycling
- body mass index 40 kg/m2 or less (to prevent "frog leg" position during cycling)
- moderate or severe traumatic brain injury
- hemodynamic instability
- pelvic or lower extremity
- injury with weight-bearing or mobilization restrictions
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
|---|---|
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Eksperimentel: Activity-based therapy
Participants will receive daily 30-minute continuous sessions of leg cycling in seated position throughout acute care, starting after surgery as soon as the patient is fit for cycling.
While the participant is seated in the armchair in the hospital room, a motorized under desk exerciser will be placed on the floor so that the feet are positioned comfortably on the pedals.
The exerciser will be positioned to ensure that maximal knee flexion during cycling will be 70 degrees.
Pedal straps are installed to secure the feet while pedaling.
Running shoes are provided to participants to prevent harmful pressure and/or friction on heels, and the risk of developing pressure injuries.
Participants will pedal at a target cadence of 40 revolutions per minute (RPM).Unless participants actively reach the target cadence of 40 RPM, motor assistance will be noted and titrated/adjusted by the research assistant until the target is reached.
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Seated cycling using motorized under desk exerciser
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Score from Item 14 of the Spinal Cord Independence Measure ranging from a minimum of 0 to a maximum of 8 (a higher score means a better outcome)
Tidsramme: 1 year
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Ambulation in the community
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1 year
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Komplikationer
Tidsramme: perioperativt/periproceduralt
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Akutte komplikationer inklusive lungebetændelse, urinvejsinfektion, trykskader, spasticitet, etc.
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perioperativt/periproceduralt
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Tilstedeværelse eller fravær af en forbedring med én American Spinal Injury Association Impairment Scale-grad fra baseline til 1 år
Tidsramme: 1 år
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Forskel i American Spinal Injury Association Impairment Scale grad mellem baseline og 1 år
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1 år
|
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Tilstedeværelse eller fravær af neuropatisk smerte
Tidsramme: 1 år
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Internationalt grunddatasæt for rygsøjleskade-smerter
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1 år
|
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Tilstedeværelse eller fravær af forbedring i motorscore med 5 point fra baseline til 1 år
Tidsramme: 1 år
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Forskel i motorscore fra baseline til 1 år
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1 år
|
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Tilstedeværelse eller fravær af forbedring i sensoriske scores med 10 point fra baseline til 1 år
Tidsramme: 1 år
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Forskel i sensoriske score mellem udgangspunktet og 1 år
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1 år
|
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Tilstedeværelse eller fravær af forbedring med 2 neurologiske niveauer af skade fra baseline til 1 år
Tidsramme: 1 år
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Forskel i neurologisk skadeniveau mellem baseline og 1 år
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1 år
|
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Total score of Spinal Cord Independence Measure ranging from a minimum of 0 to a maximum of 100 (a higher score means a better outcome)
Tidsramme: 1 year
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Functional independence
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1 year
|
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Frequence of spasms from Penn Spasm Frequency Scale ranging from a minimum of 0 to a maximum of 4 (a higher score means a worse outcome)
Tidsramme: 1 year
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Severity of spasticity
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1 year
|
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Physical component score from Short-form 36 ranging from a minimum of 0 to a maximum of 100 (a higher score means a better outcome)
Tidsramme: 1 year
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Physical component of Health-related quality of life
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1 year
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Mental component score from Short-form 36 ranging from a minimum of 0 to a maximum of 100 (a higher score means a better outcome)
Tidsramme: 1 year
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Mental component of Health-related quality of life
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1 year
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Jean-Marc Mac-Thiong, MD, PhD, Centre Integre Universitaire de Sante et Services Sociaux du Nord de l'ile de Montreal
Datoer for undersøgelser
Studer store datoer
Studiestart (Anslået)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
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IPD-planbeskrivelse
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