High Intensity Interval Exercise SCI
Condition: Spinal Cord Injuries; Cardiometabolic Diseases
MeSH terms: Spinal Cord Injuries
Study type: Interventional

Summary: 
      This study will determine if the implementation of a home-based telehealth high intensity
      interval exercise-training (HIIT)program can significantly improve cardiometabolic health and
      physical function in a cohort of individuals with longstanding spinal cord injury (SCI).
      Results from this study will determine feasibility, overall enjoyment, and health impact of
      implementing a home-based telehealth HIIT program in individuals with SCI.
    

Detailed description: 
      For individuals with spinal cord injury (SCI), exercise participation reduces the risk of
      developing chronic cardiometabolic diseases, which are leading causes of rehospitalization
      and death within this population. Accordingly, recent SCI exercise guidelines have
      highlighted a need for exercise trials that can improve cardiometabolic factors such as
      glucose tolerance, blood lipids, blood pressure, and body composition. However, to date, the
      number of exercise trials examining these cardiometabolic outcomes in SCI is low, and these
      exercise regimens are often inconvenient for individuals with SCI to perform within their
      community. In addition to the functional impairment associated with the disability,
      individuals with SCI experience a number of barriers to exercise participation, such as lack
      of time (e.g. conflict with work schedule), accessible or usable equipment and facilities,
      and transportation. Thus, it is important to identify effective modes of exercise that can
      improve overall health but do not require a significant overall weekly time commitment.
      Investigators recently demonstrated that individuals with SCI could safely perform high
      intensity interval training (HIIT) using arm crank cycling and that as few as two days per
      week of HIIT could improve cardiometabolic health. Despite the advantages of HIIT, it is
      important to identify methods of implementing exercise trials that can successfully reach and
      maintain participation in larger cohorts. Recent work by the investigative group demonstrated
      that individuals with SCI expressed favorable perceptions of home-exercise training that
      incorporated telehealth technology, which allowed a fitness specialist to remotely monitor
      participants' training progress in real-time and provide verbal support via
      videoconferencing. This method of training holds even greater value for home-exercise
      programs that require monitoring to dose-specific protocols such as HIIT. However, the
      long-term success of HIIT will greatly depend on the ease at which the program can be
      implemented, as well as participants' adherence and perceptions of using the technology,
      which has not been investigated in SCI. The goal of this study is to integrate a home-based
      telehealth HIIT arm crank exercise training program in individuals with SCI and assess
      changes in cardiometabolic health and physical function. The secondary goal is to explore the
      uptake and implementation of HIIT in SCI. 40 participants will be randomized to home-based
      HIIT exercise or a no-exercise control group for 16-weeks. Body composition, aerobic fitness,
      muscular strength, and changes in cardiometabolic health will be assessed at baseline and
      16-weeks post training. In addition to changes in cardiometabolic health outcomes, the
      investigators will also conduct interviews with participants to determine overall perceptions
      of the program, program likes and dislikes, perceived satisfaction and value, usability of
      equipment and technology, and factors that influence adherence.
    

Intervention name(s): high intensity interval exercise; No-exercise control group
Intervention type(s): Other; Other
Intervention description(s): HIIT training will be delivered two times per week for 16 weeks (32 sessions). Each session will be separated by at least 24-hrs. Participants will be allowed to choose the days and times that they feel exercise will fit into their schedule. The HIIT protocol will be determined based on peak anaerobic power measures during an arm crank Wingate Cycle test. HIIT will consist of 20 minutes of exercise consisting of four minutes of arm crank exercise at 5% of peak anaerobic power followed by 30 seconds at 30% of the peak anaerobic power; this cycle will be repeated four times, ending with two minutes of recovery at 5% of peak anaerobic power.; No-exercise control group
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: In a longitudinal study design, 40 participants with chronic SCI will be randomly assigned to one of the two study groups (HIIT and control) in a 1:1 ratio. Randomization will be performed using the block randomization method, Randomization will be performed using the block randomization method. A randomization list will be generated and assignments will be placed into closed envelopes and given to each study participant. Participants will be assessed at baseline and 16-wks post HIIT or control
Masking: None (Open Label)
Primary purpose: Prevention
Keywords: High Intensity Interval Training; Telehealth Exercise; Armcrank Exercise; SCI