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Whole Body Exercise in Spinal Cord Injury: Effects on Psychosocial Function

19. juni 2020 opdateret af: J. Andrew Taylor, Spaulding Rehabilitation Hospital
Persons with spinal cord injury (SCI) are confronted with a multitude of psychological and physiological changes post-injury leading to seemingly insurmountable barriers to participating in daily life. After injury persons with SCI engage in fewer social interactions, spend more time sedentary, and are less likely to leave the home. This leads to restricted social participation that, in turn, contributes to greater psychological problems and negatively impacts the lives of adults with SCI. Intense, structured exercise has substantial potential benefits for improving psychosocial wellbeing among persons with SCI, but accessible exercise options are few and cannot achieve high intensities of whole-body exercise. This work will use approaches to overcome the barriers to intense exercise. The investigators will use hybrid functional electrical stimulation row training (FESRT) to allow for a more intense exercise stimulus, potentially having a greater impact on psychosocial wellbeing. There is initial evidence that persons with mobility impairments who are highly physically active demonstrate better psychosocial wellbeing compared with those who have low levels of physical activity. A limitation to understanding the influence of exercise on psychosocial wellbeing is the lack of robust and time-dependent measures. The investigators will use a smartphone-based research application to measure psychosocial well-being, thus decreasing self-report bias and capturing in-the-moment behavioral and self-report data.

Studieoversigt

Status

Afsluttet

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

26

Fase

  • Ikke anvendelig

Kontakter og lokationer

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

Studiesteder

  • Forenede Stater
    • Massachusetts
      • Cambridge, Massachusetts, Forenede Stater, 02139
        • Spaulding Rehabilitation Network

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

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • Adults (>18 years of age)

    • Be in good health (asymptomatic for acute treatable illness) and medically cleared to exercise
    • Own an iPhone or Android smartphone with the capacity to download and run the research platform (able to log into to the relevant app store, install the app on their own phone, and run the app).
    • Be able to understand, communicate with and be understood by research personnel or Interpreters
    • Be interested in participating and provide informed consent
    • Have a SCI with motor or sensory deficits and use a wheelchair as primary means of mobility
    • Have an injury level only as high as C4 to allow sufficient arm function for rowing

Exclusion Criteria:

  • Participants will not have previously completed FESRT
  • Acute illness
  • Musculoskeletal injuries that have not healed completely
  • Had heart surgery or are status post-myocardial infarction (MI) in the last 4 to 6 months, -Unstable angina
  • Uncontrolled hypertension (systolic blood pressure ≥160 mm Hg and/or diastolic blood pressure ≥100 mm Hg)
  • uncontrolled dysrhythmias
  • Recent history of congestive heart failure that has not been evaluated and effectively treated
  • Severe stenotic or regurgitant valvular disease
  • Hypertrophic cardiomyopathy
  • Unhealed pressure ulcer Stage 2 or higher at relevant contact sites during exercise.

Studieplan

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

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Forebyggelse
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: FES-row-training
Subjects will perform 4 months of FES-row-raining
Andet: FES Row Training
Hybrid FES Row Training using voluntary upper body and electrically-stimulated lower body
Andet: Wait-list time control
Subjects will wait 4 months before performing being allowed to engage in 4 months of FES-row-training
Andet: FES Row Training
Hybrid FES Row Training using voluntary upper body and electrically-stimulated lower body
Aktiv komparator: Arms-only-row-training
Subjects will perform 4 months of arms-only row training before being allowed to engage in 4 months of FES-row-training
Andet: FES Row Training
Hybrid FES Row Training using voluntary upper body and electrically-stimulated lower body

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Depression
Tidsramme: Each week during the 4 months
Difference between groups in depression symptom severity (Patient Health Questionnaire-9); Within-individual Correlation of exercise intensity with depression
Each week during the 4 months
Pain Severity
Tidsramme: Each week during the 4 months
Difference between groups in pain severity, rated on a 0-10 scale ("0 being no pain and 10 being pain so severe you couldn't stand it"); Within-individual Correlation of exercise intensity with pain.
Each week during the 4 months
Pain Interference
Tidsramme: Each week during the 4 months
Difference between groups in pain interference in daily life activities ("0. Not at all 1. A little bit 2. Moderately 3. Quite a bit 4. Extremely"); Within-individual Correlation of exercise intensity with pain.
Each week during the 4 months
Anxiety
Tidsramme: Each week during the 4 months
Difference between groups in anxiety (Spinal Cord Injury Quality of Life Anxiety Short Form); Within-individual Correlation of exercise intensity with anxiety. Minimum score is 9, Maximum score is 45. Higher scores indicate higher anxiety.
Each week during the 4 months
Satisfaction with Social Participation
Tidsramme: Each week during the 4 months
Difference between groups in satisfaction with social roles and activities (Spinal Cord Injury Quality of Life Satisfaction with Social Roles and Activities Short Form); Within-individual Correlation of exercise intensity with satisfaction with social participation. The Minimum score is 20 and the maximum score is 50. Higher values indicate greater satisfaction with social participation.
Each week during the 4 months
Ability to participate in social roles
Tidsramme: Each week during the 4 months
Difference between groups in ability to participate in social roles and activities. Spinal Cord Injury Quality of Life Ability to Participate in Social Roles and Activities Short Form. Within-individual Correlation of exercise intensity with ability to participate in social roles. The Minimum score is 20 and the maximum score is 50. Higher values indicate greater satisfaction with social participation.
Each week during the 4 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Health Complications
Tidsramme: Each week during the 4 months
Difference between groups in frequency of secondary health complications; Within-individual Correlation of exercise intensity with secondary health complications.
Each week during the 4 months
Community Mobility
Tidsramme: Each week during the 4 months
Difference between groups in community mobility (Distance traveled each week); Within-individual Correlation of exercise intensity with community mobility.
Each week during the 4 months
Social Connectivity: Frequency
Tidsramme: Each week during the 4 months
Difference between groups in social connectivity (Frequency of phone calls and text messages); Within-individual Correlation of exercise intensity with frequency of social connectivity.
Each week during the 4 months
Social Connectivity: Reciprocity
Tidsramme: Each week during the 4 months
Difference between groups in social connectivity (Reciprocity of phone calls and text messages); Within-individual Correlation of exercise intensity with reciprocity of social connectivity.
Each week during the 4 months

Samarbejdspartnere og efterforskere

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

Sponsor

Spaulding Rehabilitation Hospital

Samarbejdspartnere

The Craig H. Neilsen Foundation

Efterforskere

  • Ledende efterforsker: J. Andrew Taylor, Spaulding Rehabilitation Hospital/Harvard Medical School

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 (Faktiske)

28. februar 2018

Primær færdiggørelse (Faktiske)

31. maj 2020

Studieafslutning (Faktiske)

31. maj 2020

Datoer for studieregistrering

Først indsendt

5. januar 2018

Først indsendt, der opfyldte QC-kriterier

25. januar 2018

Først opslået (Faktiske)

26. januar 2018

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

22. juni 2020

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

19. juni 2020

Sidst verificeret

1. juni 2020

Mere information

Begreber relateret til denne undersøgelse

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 2017D006049

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