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Transcutaneous Spinal Electrical Stimulation to Improve Exercise Function After Spinal Cord Injury.

2 juli 2026 bijgewerkt door: Kristine Cowley, University of Manitoba

Our overall objective is to decrease the prevalence of multiple sedentary-related diseases that are secondary consequences of spinal cord injury (SCI). SCI affects motor, sensory and autonomic systems and can cause very limited exercise capacity which then leads to very high rates of obesity, metabolic syndrome, type II diabetes and cardiovascular disease.

This randomized controlled study aims to determine whether and how transcutaneous spinal electrical stimulation (TSES) alters acute (immediate) exercise responses in people living with SCI. Exercise responses will be tested during incremental tests to fatigue, and during steady state tests. Testing will occur over several study visits and results will be compared within each individual as well as between groups (tetraplegia and paraplegia) and to a group of reference controls. A number of outcomes will be monitored, including whole-body metabolic responses using a metabolic cart, muscle responses using EMG sensors and muscle oxygenation using near infrared spectroscopy (NIRS) sensors, time to fatigue, power output, as well as perceptions about fatigue and effort.

The findings of this study are expected to provide evidence regarding whether and how TSES might improve acute exercise responses in people living with SCI.

Studie Overzicht

Toestand

Werving

Conditie

Interventie / Behandeling

Gedetailleerde beschrijving

It is well understood that SCI causes motor paralysis and sensory loss. However, it is the loss of autonomic regulation that confers the greatest morbidity to those living with SCI. Impaired exercise responses, including limited peak HR, oxygen uptake, limited catecholamine related to impaired activation of spinal sympathetic autonomic systems. Depending upon level of injury, and these sub-optimal exercise responses, there are limited exercise training effects which then leads to a calorie excess and related weight gain, cardiovascular, skeletal muscle and metabolic deconditioning that eventually causes obesity, type II diabetes and cardiovascular disease.

These sedentary-related diseases likely result in large part, because of inadequate activation of these tissues with sufficient duration or intensity to result in training effects. Therefore, we are interested in identifying means to improve acute exercise responses, with an ultimate goal of improving training responses and reducing the incidence of and/or trajectory of developing these sedentary-related diseases in individuals with SCI.

TSES has recently emerged as a potential therapeutic method to improve exercise responses. In case studies it has been shown to increase peak responses and time to fatigue during arm ergometry exercise tests.

This study is designed as a prospective, single-center, randomized controlled trial to examine whether and how TSES might alter exercise responses in two groups of people with SCI (tetraplegia and paraplegia) and a reference control group from the general population. The study is designed to assess within individual and between-group responses for a variety of outcome measures during peak and steady-state exercise tests. Study visits occur over several weeks for each participant, according to each person's time and convenience availability.

Outcomes are assessed during exercise with and without TSES in the following 4 experimental conditions:

  1. Comparing peak incremental tests to voluntary upper body exercise fatigue with or without TSES.
  2. Comparing steady state exercise responses performed at 40-45% peak power output with or without TSES.
  3. Comparing time to fatigue during neuromuscular electrical stimulation (NMES) evoked rhythmic leg contractions with or without TSES.

The primary hypothesis is that TSES will improve a variety of exercise outcomes under different experimental testing conditions and that those with tetraplegia will benefit most.

The results of this study are expected to contribute to whether and how TSES might alter acute exercise responses in those living with SCI.

The results of this study are expected to contribute to the evidence base regarding the effectiveness of TSES to alter peak and steady-state exercise responses in people with SCI and may support its integration into standard exercise training or competitive sport protocols for individuals with SCI.

Studietype

Ingrijpend

Inschrijving (Geschat)

40

Fase

  • Niet toepasbaar

Contacten en locaties

In dit gedeelte vindt u de contactgegevens van degenen die het onderzoek uitvoeren en informatie over waar dit onderzoek wordt uitgevoerd.

Studiecontact

Studie Contact Back-up

Studie Locaties

    • Manitoba
      • Winnipeg, Manitoba, Canada, R3E 0J9
        • Werving
        • University of Manitoba
        • Contact:
        • Hoofdonderzoeker:
          • Kristine Cowley, PhD
        • Hoofdonderzoeker:
          • Rodrigo Villar, PhD

Deelname Criteria

Onderzoekers zoeken naar mensen die aan een bepaalde beschrijving voldoen, de zogenaamde geschiktheidscriteria. Enkele voorbeelden van deze criteria zijn iemands algemene gezondheidstoestand of eerdere behandelingen.

Geschiktheidscriteria

Leeftijden die in aanmerking komen voor studie

  • Volwassen
  • Oudere volwassene

Accepteert gezonde vrijwilligers

Ja

Beschrijving

Inclusion Criteria:

  • traumatic or non-traumatic spinal cord injury
  • Spinal cord injury of at least one year duration, C5 or lower, AIS A - D
  • medically stable and healthy enough to engage in and complete exercise requirements
  • willing and able to complete the exercise protocols and testing requirements
  • able to understand and follow written and verbal instructions from study staff
  • able to communicate with study staff about their exercise capabilities and preferences

Exclusion Criteria:

  • current serious injury (ies) of the upper extremities
  • known cardiovascular disease
  • unsatisfactory results of EKG screening
  • implanted electronic cardiac devices (e.g., pacemaker, defibrillator, etc.)
  • current pressure ulcer(s)
  • morbid obesity
  • known thyroid dysfunction
  • current cancer
  • current uncontrolled high blood pressure
  • uncontrolled epilepsy
  • current deep vein thrombosis
  • ventilator dependency
  • cognitive impairment

Studie plan

Dit gedeelte bevat details van het studieplan, inclusief hoe de studie is opgezet en wat de studie meet.

Hoe is de studie opgezet?

Ontwerpdetails

  • Primair doel: Fundamentele wetenschap
  • Toewijzing: Gerandomiseerd
  • Interventioneel model: Crossover-opdracht
  • Masker: Dubbele

Wapens en interventies

Deelnemersgroep / Arm
Interventie / Behandeling
Ander: Upper body exercise in participants with tetraplegia
TSES during peak and steady state exercise in those with tetraplegia
TSES will typically involve constant current rectangular pulse bipolar stimulation delivered at 20 Hz with stimulation durations of 900 microseconds delivered at or slightly above motor threshold.
Ander: Upper body exercise in participants with paraplegia
TSES during peak and steady state exercise in those with paraplegia
TSES will typically involve constant current rectangular pulse bipolar stimulation delivered at 20 Hz with stimulation durations of 900 microseconds delivered at or slightly above motor threshold.
Ander: Upper body exercise in reference control participants
TSES during peak and steady state exercise in reference controls
TSES will typically involve constant current rectangular pulse bipolar stimulation delivered at 20 Hz with stimulation durations of 900 microseconds delivered at or slightly above motor threshold.
Ander: Rhythmic lower limb neuromuscular electrical stimulation evoked exercise
Does TSES alter time to fatigue during NMES-evoked rhythmic lower limb exercise?
TSES will typically involve constant current rectangular pulse bipolar stimulation delivered at 20 Hz with stimulation durations of 900 microseconds delivered at or slightly above motor threshold.

Wat meet het onderzoek?

Primaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Oxygen uptake
Tijdsspanne: During individual study visits lasting between 1 and 2.5 hours
Oxygen uptake, in mL/min
During individual study visits lasting between 1 and 2.5 hours
Perceived Exertion
Tijdsspanne: Tested intermittently during individual voluntary exercise study visits lasting between 1 and 2.5 hours
Ratings of perceived exertion, on a Borg scale of 6 to 20 with 6 being resting to 20 which is very very hard.
Tested intermittently during individual voluntary exercise study visits lasting between 1 and 2.5 hours
Time to fatigue during incremental exercise tests to fatigue
Tijdsspanne: Time to fatigue will be monitored during study visits lasting between 1 and 2.5 hours.
Does TSES alter time to fatigue during NMES-evoked rhythmic lower limb exercise, measured in seconds.
Time to fatigue will be monitored during study visits lasting between 1 and 2.5 hours.
Heart rate
Tijdsspanne: During exercise testing study visits, lasting between 1 and 3 hours
Heart rate, beats per minute
During exercise testing study visits, lasting between 1 and 3 hours
Power output
Tijdsspanne: During exercise in study visits lasting 1 to 3 hours.
Watts
During exercise in study visits lasting 1 to 3 hours.

Secundaire uitkomstmaten

Uitkomstmaat
Maatregel Beschrijving
Tijdsspanne
Muscle tissue oxygen saturation levels
Tijdsspanne: Oxygen saturation levels will be assessed during study visits lasting between 1 and 2.5 hours.
Does TSES alter muscle tissue oxygen saturation levels during exercise, expressed as a percentage.
Oxygen saturation levels will be assessed during study visits lasting between 1 and 2.5 hours.

Medewerkers en onderzoekers

Hier vindt u mensen en organisaties die betrokken zijn bij dit onderzoek.

Sponsor

Onderzoekers

  • Hoofdonderzoeker: Kristine Cowley, Phd, University of Manitoba
  • Hoofdonderzoeker: Rodrigo Villar, PhD, University of Manitoba

Studie record data

Deze datums volgen de voortgang van het onderzoeksdossier en de samenvatting van de ingediende resultaten bij ClinicalTrials.gov. Studieverslagen en gerapporteerde resultaten worden beoordeeld door de National Library of Medicine (NLM) om er zeker van te zijn dat ze voldoen aan specifieke kwaliteitscontrolenormen voordat ze op de openbare website worden geplaatst.

Bestudeer belangrijke data

Studie start (Werkelijk)

10 juni 2024

Primaire voltooiing (Geschat)

1 augustus 2026

Studie voltooiing (Geschat)

1 oktober 2026

Studieregistratiedata

Eerst ingediend

29 mei 2026

Eerst ingediend dat voldeed aan de QC-criteria

2 juli 2026

Eerst geplaatst (Werkelijk)

9 juli 2026

Updates van studierecords

Laatste update geplaatst (Werkelijk)

9 juli 2026

Laatste update ingediend die voldeed aan QC-criteria

2 juli 2026

Laatst geverifieerd

1 mei 2026

Meer informatie

Termen gerelateerd aan deze studie

Andere studie-ID-nummers

  • HS26003

Plan Individuele Deelnemersgegevens (IPD)

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ONBESLIST

Beschrijving IPD-plan

To maintain participant confidentiality

Informatie over medicijnen en apparaten, studiedocumenten

Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel

Nee

Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct

Nee

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