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Protocol for Rapid Onset of Mobilization in Patients With Traumatic Spinal Cord Injury III (PROMPT-SCI III) Trial (PROMPT-SCI III)

This longitudinal cohort study will investigate the clinical benefits of early acute exercise therapy after mild spinal cord injury (SCI). The hypothesis is that early acute exercise therapy after mild SCI will improve neurofunctional recovery (walking, functional independence, motor and sensory recovery) and quality of life one year after the SCI, while decreasing complications during acute care and reducing the care burden (shorter hospital stay and home discharge more likely). For this study, 107 participants with mild 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. Neurofunctional recovery, quality of life, acute complications and care burden for the participants performing early acute cycling will be compared to a control cohort of patients with mild SCI who did not receive exercise therapy during acute care.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

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

Interventionel

Tilmelding (Anslået)

107

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

    • Quebec
      • Montreal, Quebec, Canada, h4j1c5
        • Hôpital du Sacré-Cœur de Montréal
        • Kontakt:
        • Ledende efterforsker:
          • Jean-Marc Mac-Thiong, MD, PhD
        • Ledende efterforsker:
          • Andreane Richard-Denis, MD, MSc

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

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

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
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.
Seated cycling using motorized under desk exerciser

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
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
Ambulation in the community
1 year

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Komplikationer
Tidsramme: perioperativt/periproceduralt
Akutte komplikationer inklusive lungebetændelse, urinvejsinfektion, trykskader, spasticitet, etc.
perioperativt/periproceduralt
Tilstedeværelse eller fravær af en forbedring med én American Spinal Injury Association Impairment Scale-grad fra baseline til 1 år
Tidsramme: 1 år
Forskel i American Spinal Injury Association Impairment Scale grad mellem baseline og 1 år
1 år
Tilstedeværelse eller fravær af neuropatisk smerte
Tidsramme: 1 år
Internationalt grunddatasæt for rygsøjleskade-smerter
1 år
Tilstedeværelse eller fravær af forbedring i motorscore med 5 point fra baseline til 1 år
Tidsramme: 1 år
Forskel i motorscore fra baseline til 1 år
1 år
Tilstedeværelse eller fravær af forbedring i sensoriske scores med 10 point fra baseline til 1 år
Tidsramme: 1 år
Forskel i sensoriske score mellem udgangspunktet og 1 år
1 år
Tilstedeværelse eller fravær af forbedring med 2 neurologiske niveauer af skade fra baseline til 1 år
Tidsramme: 1 år
Forskel i neurologisk skadeniveau mellem baseline og 1 år
1 år
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
Functional independence
1 year
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
Severity of spasticity
1 year
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
Physical component of Health-related quality of life
1 year
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
Mental component of Health-related quality of life
1 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

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

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. september 2026

Primær færdiggørelse (Anslået)

31. januar 2031

Studieafslutning (Anslået)

31. januar 2031

Datoer for studieregistrering

Først indsendt

27. august 2026

Først indsendt, der opfyldte QC-kriterier

27. august 2026

Først opslået (Faktiske)

1. september 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

2. september 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

31. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • ciusss-nordmtl

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

IPD-planbeskrivelse

The IPD collected for the study are not publicly available. However, IPD will be made available to others upon reasonable request, and with permission from our Ethics committee.

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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