This initiative represents development and pilot testing of a circuit training exercise program for persons with spinal cord injury (SCI) to be implemented within a rehabilitation centre. The program will integrate members of the community who are \> 18 months post-injury with those currently participating in SCI rehabilitation as inpatient.
This initiative represents development and pilot testing of a 16 week circuit training exercise program for persons with spinal cord injury (SCI) to be implemented within a rehabilitation centre (Parkwood Institute, London, ON). The primary purpose of this trial is one of feasibility - i.e., testing out several aspects of the trial for the purposes of determining what features of the exercise intervention and the various outcome measurements might be a part of subsequent trials. In addition, a subset of this data will serve as preliminary comparison information for Dr. Dany Gagnon's study at the University of Montreal. In this way, this is not a true multi-centre trial in that we are not conducting an identical protocol to a study he is conducting. Rather, we are using some of the same outcome measures and an exercise intervention that has some similar parameters to one that he is implementing in Montreal - with a view to providing a preliminary comparison of outcomes of a subset of participants in our study so as to inform the development of future studies. For this reason, the group of community-dwelling persons with SCI will have more cardio-metabolic outcome measurements taken, as they represent the primary group of interest to Dr. Gagnon. Overall, the program will integrate members of the community who are \> 18 months post-injury (n=8) with those currently participating in SCI rehabilitation as inpatients (n=8). Outcomes will be collected to test the effects of the program on an array of cardio-metabolic measures in those participants with chronic SCI, as well as the feasibility of the program for all participants (N=16). Note: although a participant can decline to continue participation at any time, it is likely that many inpatient participants will choose to not continue participation if this proves logistically difficult (if they move back to their home community away from London).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
16
16 week seated upper body exercise for persons with Spinal Cord Injuries. Participants will attend 2-3 exercise sessions a week, sessions have a mix of SCI community members and inpatients.
Feasibility survey
Feasibility question options range from -3 to +3 on a likert scale, higher scores indicated a greater level of feasibility.
Time frame: After Study Completion (16 weeks)
Injury Characteristics Survey
Date of injury (DD/MM/YYYY)
Time frame: Baseline
Injury Characteristics Survey
Diagnosis - Traumatic SCI or Non-Traumatic SCI
Time frame: Baseline
Injury Characteristics Survey
Classification of SCI using the AIS (ASIA Impairment Scale) - A, B, C, D or E
Time frame: Baseline
Injury Characteristics Survey
Neurological Level or Injury (NLI)
Time frame: Baseline
Change in Spinal Cord Injury Independence Measure - Mobility
Assessment of degree to which participant can independently preform mobility tasks, such as transfers, and the ue of mobility aids.
Time frame: Baseline and 16 weeks
Change in Upper and Lower Extremity Strength by a manual muscle test (MMT)
Assessment of joint (Shoulder, elbow, wrist, hip, knee and ankle) muscle strength using a Manual muscle test.
Time frame: Baseline and 16 weeks
Change in Upper and Lower Extremity Range of Motion
Assessment of joint range of motion in the upper and lower extremities (Shoulder, elbow, wrist, hip, knee and ankle)
Time frame: Baseline and 16 weeks
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Change in Spasticity in upper and lower extremities using the Modified Ashworth Scale
Assessment of muscle tone through range of motion, on a scale of 0-4 (0= no increase in muscle tone; 4 = rigidity in flexion or extension)
Time frame: Baseline and 16 weeks
Change in Maximal Safe Wheel chair speed measured using the Propulsion Speed Test
20 meter straight line wheel chair speed test. 3 trails were be preformed at a comfortable speed and 3 trials will be preformed at a maximal but safe speed.
Time frame: Baseline and 16 weeks
Change in Ability to safety navigate wheel chair using the Slalmon Speed test
Objective is to weave between a set of cones without touching them as fast as safely possible. 3 attempts will be given.
Time frame: Baseline and 16 weeks
Demographics and Lifestyle Questionnaires
Age in years
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Gender (Women, Man or Other)
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Marital Status
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Ethnicity
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Highest Education Level completed
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Currently Employment situation
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Family income ($ in last year)
Time frame: Baseline
Demographics and Lifestyle Questionnaires
List of Medical/health problems
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Smoking levels (yes/no and how many years)
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Cannabis Use (yes/no, frequency, types of products)
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Vaping (Yes/no, frequency)
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Alcohol consumption (frequency and beverages consumed when drinking)
Time frame: Baseline
Demographics and Lifestyle Questionnaires
Physical Activity levels (minutes/week)
Time frame: Baseline
Change in Medications
List of medication and supplements currently being taken.
Time frame: Baseline and 16 weeks
Change in Experienced Pain
The international Spinal Cord Injury Pain Data Set will be used to evaluate the presence and severity of pain. Description of 3 main pain concerns and there intensity. Intensity ranges from 0 = no pain to 10 = worst possible pain.
Time frame: Baseline and 16 weeks
Change in Wheel Chair skills ability using the Wheel Chair skills Test Questionnaire
Questionnaire assesses the ability and confidence in preforming numerous wheel chair skills (ex: turning the wheelchair around a small space) Questions answers include 'No' 'partially' 'yes' 'very well'.
Time frame: Baseline and 16 weeks
Change in Well Being measured by the General Wellbeing Index
Assessment of emotional wellbeing, on a scale of 0-5.
Time frame: Baseline and 16 weeks
Change in Quality of life and health measured by the WHOQOL-BREF
Self reported questionnaire assessing quality of life (physical, social, environment and psychological health) on a scale of 1 - 4 (1=poor/not al all; 5= very good/extreme amount)
Time frame: Baseline and 16 weeks
Change in aerobic capacity (VO2max) measured by 6-min wheelchair propulsion test
Objective is to get the largest total distance. Pylons are placed 25meters apart, participants starts in the middle go around the first cone to the let return to the middle and make a full stop, then continue to the right of second cone, go around it and back to the middle, making a figure 8. Continue that pattern for 6 minutes.
Time frame: Baseline and 16 weeks
Blood Test
Measurement of metabolic profile (ex: glucose, insulin, triglyceride)
Time frame: Baseline and 16 weeks
Blood Test
Measurement of bone markers (ex: osteocalcin)
Time frame: Baseline and 16 weeks
Change in Body composition measured by DEXA (Dual energy x-ray absorptiometry)
Measurement of bone mineral density of the full body (reported using a T score)
Time frame: Baseline and 16 weeks
Change in Body composition measured by DEXA (Dual energy x-ray absorptiometry)
Measurement of bone mineral density of the femoral head (reported using a T score)
Time frame: Baseline and 16 weeks
Change in Body composition measured by DEXA (Dual energy x-ray absorptiometry)
Measurement of bone mineral density of the lumbar spine (reported using a T score)
Time frame: Baseline and 16 weeks