Personalized Cardiorespiratory Fitness Training in Patients With Incomplete Spinal Cord Injury During Primary Rehabilitation
试验速览
- 阶段
- 不适用
- 状态
- 终止
- 入组人数
- 19
- 试验地点
- 1
- 主要终点
- Change in cardiorespiratory fitness
研究概览
简要总结
The goal of this exploratory randomized controlled trial is to assess the effect of a personalized training intervention during primary rehabilitation of 6 weeks on cardiorespiratory fitness in individuals with subacute (<6 months) spinal cord injury during primary rehabilitation and during follow-up. Secondary outcomes include the effect on gait assessments, pulmonary function, neurological status, muscle force, cardiometabolic risk factors, quality of life, functional independence and self-efficacy.
Participants in the intervention group will receive 2-3 personalized cardiorespiratory fitness-focused training sessions per week, for a period of 6 weeks. Participants in the control group will receive usual care.
详细描述
Rationale:
Despite advances in medical care, spinal cord injury (SCI) patients have significantly lower survival rates compared to the general population. The 'Koepelproject', an unique world-leading multi-center research project, discovered that SCI patients have a decreased pulmonary function, which is linked to poor cardiorespiratory fitness (CRF). This leads to respiratory and cardiovascular diseases, which are important predictors of death in SCI patients. However, there are limitations of the 'Koepelproject' which highlight the need for the proposed project 'FIT@HOME'. Rehabilitation knowledge in SCI patients is primarily focused on those with a complete lesion, while there has been changes in the characteristics of the SCI population over the last few decades. The diagnosis of an incomplete SCI (iSCI) is more common and requires different insights and skills compared to patients with complete lesions. Therefore, insight in the effect of personalized rehabilitation strategies focussed on CRF during primary rehabilitation will provide important information to support healthy ageing in iSCI patients.
Objective:
The primary aim of this study is to assess the effect of a personalized training intervention on CRF during primary rehabilitation and at follow-up. Secondary aims of this study are to determine the effect of this training intervention on gait capacity, pulmonary function, neurological status, muscle force, cardiometabolic risk factors, quality of life (QoL), functional independence and exercise self-efficacy.
Study design:
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Diagnosis of incomplete spinal cord injury based on a stable cause (e.g. traumatic)
- •Spinal cord injury classification C or D on the American Spinal Injury Association (ASIA) impairment scale
- •During this study in the subacute phase (< 6 months post injury)
- •Hospitalized in the Sint Maartenskliniek for a primary, inpatient rehabilitation program
- •Older than 18 years of age
- •Able to understand and perform study related procedures
- •Capable to sit at least 3 times a day for 2 hours (prerequisites to start the active rehabilitation program)
- •The ability to use an arm ergometer
排除标准
- •Unable to give informed consent
- •Language barrier
- •Participating in another interventional study targeting cardiorespiratory fitness
- •Have contraindications to perform exercise during the rehabilitation program
研究组 & 干预措施
Intervention group
During the primary rehabilitation program, the intervention group will receive 2-3 individualized cardiorespiratory fitness training sessions per week.
干预措施: Cardiorespiratory fitness (CRF) training (Other)
Control group
The control group will receive usual care.
结局指标
主要结局
Change in cardiorespiratory fitness
时间窗: Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6)
Defined as VO2peak in ml/kg/min
次要结局
- Gait assessments - Gait capacity(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), 2 weeks after T2 (T3), end of outpatient rehab (T4) (average 3 months after T2) , 2 weeks after T4 (T5), 3 months after end of outpatient rehab (T6))
- Gait assessments - Walking ability(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), 2 weeks after T2 (T3), end of outpatient rehab (T4) (average 3 months after T2) , 2 weeks after T4 (T5), 3 months after end of outpatient rehab (T6))
- Gait assessments - Gait performance(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), 2 weeks after T2 (T3), end of outpatient rehab (T4) (average 3 months after T2) , 2 weeks after T4 (T5), 3 months after end of outpatient rehab (T6))
- Pulmonary function - Forced Vital Capacity (FVC)(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Pulmonary function - Forced Expiratory Volume in 1 second (FEV1)(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Pulmonary function - Peak Expiratory Flow (PEF)(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Neurological status(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Waist circumference (cm)(Baseline (T0) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Skinfold thickness(Baseline (T0) , 3 months after end of outpatient rehab (T6))
- Muscle force - Grip force(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Muscle force - Voluntary muscle strength(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Blood pressure(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Heart rate(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Total Cholesterol (TC)(Baseline (T0) , 3 months after end of outpatient rehab (T6))
- Secondary complications - Shoulder pain(Baseline (T0), 6 weeks after T0 (T1))
- Secondary complications - Number of respiratory and cardiovascular complications(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Secondary complications - Number of rehospitalizations(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Low Density Lipoprotein Cholesterol (LDL-C)(Baseline (T0) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - High Density Lipoprotein Cholesterol (HDL-C)(Baseline (T0) , 3 months after end of outpatient rehab (T6))
- Secondary complications - Urinary and bowel dysfunction(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Fasted insulin(Baseline (T0) , 3 months after end of outpatient rehab (T6))
- Cardiometabolic risk factors - Fasted glucose(Baseline (T0) , 3 months after end of outpatient rehab (T6))
- Secondary complications - Level of fatigue experienced during the last week(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Secondary complications - Pressure sores(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Secondary complications - Spasticity(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Secondary complications - Level of pain experienced during the last week(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), end of outpatient rehab (T4) (average 3 months after T2) , 3 months after end of outpatient rehab (T6))
- Exercise self-efficacy(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), 2 weeks after T2 (T3), end of outpatient rehab (T4) (average 3 months after T2) , 2 weeks after T4 (T5), 3 months after end of outpatient rehab (T6))
- Quality of Life (QoL)(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), 2 weeks after T2 (T3), end of outpatient rehab (T4) (average 3 months after T2) , 2 weeks after T4 (T5), 3 months after end of outpatient rehab (T6))
- Functional independence(Baseline (T0), 6 weeks after T0 (T1), end of inpatient rehab (T2)* (average 3 months after T0), 2 weeks after T2 (T3), end of outpatient rehab (T4) (average 3 months after T2) , 2 weeks after T4 (T5), 3 months after end of outpatient rehab (T6))