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Physical Fitness, Exercise Self-efficacy, Physical Activity Level in People With Spinal Cord Injury (SCI)

Not Applicable
Conditions
Spinal Cord Injuries
Physical Disability
Interventions
Other: Conventional Physical Therapy
Other: Graded Exercise Integrated Education
Registration Number
NCT03420170
Lead Sponsor
Universiti Teknologi Mara
Brief Summary

This is a single blind randomized controlled trial study which will conducted on people with paraplegia wheelchair users. The objectives of this study is to investigates the effects of 16 weeks of 'Graded Exercise Integrated Education' over conventional physical therapy on physical fitness, exercise self-efficacy and the level of physical activity. There will be a significant difference between the experimental and control group.

Detailed Description

A study protocol will be a single blinded randomised controlled trial. 40 subjects with diagnosed of paraplegia (T1 and below) and dependent with wheelchair will be randomly assigned into 2 groups, Graded exercise (n=20) or Conventional Physical Therapy (n=20). In 8 weeks, the graded exercise group will receive strengthening and aerobic exercise for 2 times a week, and the controlled group will continue their normal routine. The strengthening exercise will consist of strength training for major upper limb muscles in the multigym station and free weights dumbbell whereas the aerobic exercise will perform by using arm ergometry, boxing and wheelchair wheeling. The exercise will be graded and progressed for each week in 8 weeks. The graded exercise group also will receive educational intervention to increase the exercise self-efficacy and physical activity level which will conduct in face to face for 2 times a week in 8 weeks during in-rehabilitation program and once on every 4 weeks in 8 weeks after discharge from in-rehabilitation program. The outcomes are the strength and endurance of upper limb which will be measure by using a BIODEX® Isokinetic Machine and hand grip strength by JAMAR® Hand-held dynamometry. The cardiovascular endurance will be measure by using 6 minute wheelchair push test (6MWPT). The exercise self-efficacy and physical activity level will be measure by using 'Exercise Self-Efficacy Scale (ESES)' and 'Physical Activity Scale for Individual with Disability (PASIPD)'. The outcome measure will be evaluated at the baseline level, week 4th, week 8th, week 12th, and 16th. Statistical analysis will be carried out using the SPSS 21.0 program for Windows and a significant level of p ≤ 0.05 will be used for all tests.

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Traumatic and Non-traumatic paraplegia
  • Wheelchair dependent
  • Age range between 18 and 65 years old
Exclusion Criteria
  • Pregnancy
  • Individual who suffered from progressive neurological diseases, depression and mental disorder
  • Individual with frequent autonomic dysreflexia and hypotension
  • Individual with comorbid recent fracture
  • Individual with severe heart diseases and pain
  • Individual who not understand Malay and English
  • Individual who not understand instructions and obey commands
  • Individual who difficult to reach via telephone, email or social media

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Conventional physical therapyConventional Physical TherapyNormal routine of physical therapy (8 weeks)
Graded Exercise Integrated EducationGraded Exercise Integrated EducationThe graded exercise (8 weeks) 1. Strengthening exercise 2. Aerobic Exercise Educational session to increase exercise self-efficacy and physical activity level (16 weeks)
Primary Outcome Measures
NameTimeMethod
Cardiovascular fitnessChange from baseline of cardiovascular endurance at 4 months

6-Minute Wheelchair Push Test (6-MWPT)

Muscle strengthChange from baseline of upper limbs strength at 4 months

The upper limb strength measure by using BIODEX ® Isokinetic machine

Muscle strength normalize with body weightChange from baseline of upper limbs strength normalize body weight at 4 months

The upper limb strength normalize with body weight measure by using BIODEX ® Isokinetic machine

Exercise self-efficacyChange from baseline of exercise self-efficacy at 4 months

The Spinal Cord Injury Exercise Self-Efficacy (ESES)

Muscle enduranceChange from baseline of upper limbs endurance at 4 months

The upper limb endurance measure by using BIODEX ® Isokinetic machine

Grip strengthChange from baseline of grip strength at 4 months

The JAMAR ® hand held dynamometer

Physical activity levelChange from baseline of physical activity level at 4 months

The Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)

Secondary Outcome Measures
NameTimeMethod
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