Effects of Exercise in People With Paraplegia
Condition: Spinal Cord Injury
MeSH terms: Spinal Cord Injuries; Paraplegia
Study type: Interventional

Summary: 
      This hypothesis-driven study will investigate effects of physical activity with or without a
      nutrient supplement known to increase body lean mass in adults with chronic paraplegia who
      have clusters of obesity and obesity-related secondary complications.
    

Detailed description: 
      Obesity and obesity-related secondary complications are pandemic health hazards that are
      highly prevalent among persons with spinal cord injuries (SCI). Accumulation of body fat
      disposes persons with SCI to accelerated endocrine and cardiovascular diseases, as well as
      pain, functional decline, and diminished health-related quality of life (HRQoL). While use of
      combined resistance and endurance exercise by persons without disability can remedy many of
      the problems associated with these disorders, their widespread use for persons with spinal
      cord injuries (SCI) must first satisfy scientific burdens of effectiveness.

      The investigators have adopted the term "obesity-related secondary complications" to describe
      accumulation of body fat clustering with other secondary CVD risks, while recognizing that a
      threshold criterion for diagnosis of obesity in persons with SCI remains ill-defined. For
      purposes of this proposal, the "-related" part of the term confers physical deconditioning,
      hypertension, fasting dyslipidemia, post-prandial lipemia (PPL), and impaired insulin
      sensitivity, all of which have been reported in persons with SCI. Contextualized, any of
      these risks occurring independently or in clusters would be cause for immediate therapeutic
      lifestyle intervention (TLI), if not frank medical treatment. Given our early understanding
      of effective treatments for these risks, any improvement in their severity would be CVD
      risk-reducing and thus life-benefiting and function-preserving.

      The investigators expect that the research findings will improve the understanding of risks
      for obesity and obesity-related secondary complications so that future interventions can be
      better targeted, identify an exercise intervention that can attend to current health risks,
      clarify whether nutrient supplementation improves risk-lessening benefits of exercise,
      identify exercise timing and intensities that best enhance fat utilization, and expand the
      understanding of the interrelated nature of risk factors after SCI.
    

Intervention name(s): Exercise
Intervention type(s): Other
Intervention description(s): CRT will occur 3 times per week for 26 weeks. Each training session will last approximately 40-45 minutes and employ resistance training (weight lifting) and high-speed, low intensity endurance activities (arm cranking) with interposed periods of incomplete recovery (i.e., heart rate not falling to baseline).
Other intervention name(s): Circuit Resistance Training (CRT)
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Prevention