Persons with chronic paraplegia at an increased risk of developing cardiovascular disease and type-2 diabetes compared to the able-bodied population. There is mounting evidence from the able-bodied literature that high-intensity interval training (HIIT) is an effective way to improve cardiometabolic health outcomes, but this effect has yet to be investigated in persons with chronic paraplegia. This study is recruiting adults (aged 18-65 years) with paraplegia (T2 or below) who sustained their spinal cord injury more than one-year ago. Participants will need to attend the laboratory at the University of Bath on two occasions (baseline and follow-up testing) separated by eight weeks. Following the first visit, participants will be randomised to a exercise group or control group. For those in the exercise group, participants will be provided with an arm crank ergometer for use in their home, and be asked to perform four exercise sessions per week (30 min each) for six weeks. For those in the control group, participants will be asked to continue their normal lifestyle.
The aim of this research is to determine the effect of HIIT (vs. a control group) on biomarkers of cardiometabolic health in persons with chronic paraplegia. Baseline and follow-up assessments: Before each visits, participants will be asked to refrain from any strenuous physical activity (2 days prior), consume no caffeine (including tea or coffee) or alcohol (1 day prior), and have fasted for at least 10 hours overnight before arriving to the University of Bath laboratories. There will be measurements of basic anthropometrics (height, weight, waist and hip circumference), body composition (via a DEXA scan), resting metabolic rate, sub-maximal and maximal exercise capacity, and blood responses following the consumption of a sugary drink. Physical activity and diet monitoring: Participants will be asked to monitor their normal diet (weighed food diary) and physical activity patterns (chest-worn strap) over a 1-week period following the first visit, and in the final week of the 6-week intervention/control period. Exercise intervention: The 6-week exercise programme or control will start two weeks after the first lab visit. Participants in the exercise group will be asked to wear a heart-rate monitor for all exercise sessions, and upload their data to a smartphone for remote-monitoring by the research team.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Arm-cranking exercise
University of Bath
Bath, United Kingdom
RECRUITINGFasting insulin
Serum insulin concentration
Time frame: 6 weeks
Peak aerobic capacity
Measured using a incremental ramp protocol on a arm crank ergometer
Time frame: 6 weeks
Peak power output
Maximum power output achieved during peak aerobic capacity test
Time frame: 6 weeks
Body mass
Measured using electronic wheelchair scales
Time frame: 6 weeks
Waist and hip circumference
Measured using a non-metallic tape
Time frame: 6 weeks
Total body fat percentage
Measured using duel-energy x-ray absorptiometry
Time frame: 6 weeks
Total Fat Mass
Measured using duel-energy x-ray absorptiometry
Time frame: 6 weeks
Total Fat-Free Mass
Measured using duel-energy x-ray absorptiometry
Time frame: 6 weeks
Visceral Adipose Tissue
Measured using duel-energy x-ray absorptiometry
Time frame: 6 weeks
Systolic and diastolic blood pressure
Measuring using a automated sphygmomanometer
Time frame: 6 weeks
Resting metabolic rate
Measured using indirect calorimetry
Time frame: 6 weeks
Time spent in different physical activity intensities (MET categories) (minutes)
Time spent in different physical activity intensities across 7-days (MET categories) (minutes)
Time frame: 6 weeks
Energy expended in different physical activity intensities (MET categories) (kJ or kcal)
Energy expended in different physical activity intensities across 7-days (MET categories) (kJ or kcal)
Time frame: 6 weeks
Energy intake and dietary macronutrient composition
Estimated using a 7-day weighed food diary
Time frame: 6 weeks
Fasting metabolite/hormone/inflammatory profile
Assessment of blood glucose, glycated hemoglobin, triglycerides, non-esterified fatty acids, total cholesterol, high density lipoprotein, and low density lipoprotein concentrations, leptin, C-reactive protein, interleukin-6, tumour-necrosis factor-alpha, and adiponectin
Time frame: 6 weeks
Postprandial metabolites
Assessment of blood glucose and insulin
Time frame: 6 weeks
Shoulder Pain
Measured using a validated questionnaire
Time frame: 6 weeks
Exercise Self-Efficacy
Measuring using a validated questionnaire
Time frame: 6 weeks
Health-related quality of life
Measured using a validated questionnaire
Time frame: 6 weeks
Fatigue
Measured using a validated questionnaire
Time frame: 6 weeks
Independence
Measured using a validated questionnaire
Time frame: 6 weeks
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