The long-term goal of this project is to improve the overall cardiometabolic health of persons with spinal cord injury (SCI). This pilot study will test the feasibility and acceptability of remote ischemic conditioning implemented in a home setting by persons with SCI and collect cardiometabolic health outcomes to inform appropriate outcomes for a future larger trial. Researchers will compare, RIC high dose using standard blood pressure cuff to RIC high dose using automated blood flow restriction cuff to RIC low dose using standard blood pressure cuff, to determine cardiometabolic health improvements amongst groups. Participants will: Complete an initial 2-day assessment, participate in a 6-week intervention using remote ischemic conditioning (RIC) within their home, complete a 2-day post assessment.
The goal of this clinical trial is to collect preliminary data on examining the effects of remote ischemic conditioning (RIC) on cardiometabolic health outcomes for persons with spinal cord injury (SCI). The main aims are: To identify barriers, facilitators and reasons for positive determinants for implementation of RIC in a home setting. To estimate improvements in cardiometabolic health of participants with SCI enrolled in an in-home, high-dose RIC intervention group compared to a low-dose RIC group. The long-term impact will be implementing evidence-based interventions that are achievable and accessible to persons with SCI for improving cardiovascular and metabolic morbidity and mortality outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
BASIC_SCIENCE
Masking
NONE
Enrollment
24
The RIC high-dose using a standard blood pressure cuff group will participate in 6-weeks of self or support-person applied/assisted remote ischemic conditioning (RIC) intervention within their home. 5 days a week the participants will complete 1 session of 4 cycles of inflating/deflating a standard blood pressure cuff to 20 mmHg higher than their measured systolic blood pressure on an arm. The blood pressure cuff will be inflated and held for 5 minutes, then deflated (released) for 5 minutes and this will be repeated a total of 4 cycles. This process will take about 35 minutes to complete each day. The participants will also complete a daily log of their RIC sessions. The overall goal is to improve cardiometabolic health of persons with spinal cord injury.
The RIC high-dose automated blood flow restriction cuff group will participate in 6-weeks of self or support-person applied/assisted remote ischemic conditioning (RIC) intervention within their home. 5 days a week the participants will complete 1 session of 4 cycles of inflation/deflation of an automated blood flow restriction cuff to 20 mmHg higher than their measured systolic blood pressure on an arm. The restriction cuff will inflate and hold for 5 minutes, then deflate (release) for 5 minutes and this will be repeated a total of 4 cycles. This process will take about 35 minutes to complete each day. The participants will also complete a daily log of their RIC sessions. The overall goal is to improve the cardiometabolic health of persons with spinal cord injury.
The RIC low-dose standard blood pressure cuff group will participate in 6-weeks of self or support-person applied/assisted remote ischemic conditioning (RIC) intervention within their home. 5 days a week the participants will complete 1 session of 4 cycles of inflating/deflating a blood pressure cuff to 10 mmHg below their measured diastolic blood pressure on an arm. The blood pressure cuff will be inflated and held for 5 minutes, then deflated (released) for 5 minutes and this will be repeated a total of 4 cycles. This process will take about 35 minutes to complete each day. The participants will also complete a daily log of their RIC sessions.
Washington University School of Medicine
St Louis, Missouri, United States
RECRUITINGBrachial artery diameter change (cm)
Participants will undergo a Brachial Artery Reactivity Test (BART) via upper arm doppler ultrasound. The test will measure flow-mediated dilation and endothelium independent dilation of the brachial artery using a high-resolution transducer on the Vivid E95, E9, Vivid IQ (portable) or Vivid I (portable) systems. Brachial artery flow-mediated vasodilation correlates with measures of coronary artery endothelial function and can predict future adverse coronary events. Results will be reported as brachial artery diameter change between baseline and 30 seconds into test, unit of measure is cm.
Time frame: Baseline and up to 2 weeks post intervention
Arterial stiffness - Pulse wave velocity (PWV)
This test is a non-invasive cardiovascular assessment that measures arterial stiffness. Arterial stiffness will be obtained by measuring carotid-femoral pulse wave velocity using the SphygmoCor XCEL system.
Time frame: Baseline and up to 2 weeks post intervention
Inflammation change - High sensitivity C reactive protein - hsCRP - (mg/L, reported as % change)
Participants will have blood drawn two times at initial assessment and two times at post assessment. The first draw will happen immediately before a session of remote ischemic conditioning (RIC) and then immediately after the session. The hsCRP results will measure inflammation within the body, elevated hsCRP levels are associated with an increased risk of cardiovascular disease.
Time frame: Baseline and up to 2-weeks post intervention
Immune system activation/response change - Interleukin 6 - IL-6 - (pg/mL, reported as % change)
Participants will have blood drawn two times at initial assessment and two times at post assessment. The first draw will happen immediately before a session of remote ischemic conditioning (RIC) and then immediately after the session. The IL-6 results will measure pro- and anti- inflammatory responses, this will be reported as one score, higher levels are associated with an increased pro-inflammatory response and lower levels are associated with an anti-inflammatory response.
Time frame: Baseline and up to 2-weeks post intervention
Low density lipoprotein cholesterol (LDL) change - (mg/dL, reported as % change)
Participants will have blood drawn one time at initial assessment and one time at post assessment. The LDL results will measure the amount of LDL within the blood. High levels of LDL can lead to plaque buildup in the arteries, increasing the risk of cardiovascular disease.
Time frame: Baseline and up to 2-weeks post intervention
High-density lipoprotein cholesterol (HDL) change - (mg/dL, reported as % change)
Participants will have blood drawn one time at initial assessment and one time at post assessment. The HDL results will measure the amount of HDL within the blood. High levels of HDL are associated with a lower risk of cardiovascular disease.
Time frame: Baseline and up to 2-weeks post intervention
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.