High-intensity Interval Training and Mixed Meal Responses in Persons With Spinal Cord Injury
Condition: Paraplegia
MeSH terms: Paraplegia
Study type: Interventional

Summary: 
      Persons with chronic paraplegia at an increased risk of developing cardiovascular disease and
      type-2 diabetes compared to the able-bodied population. There is mounting evidence from the
      able-bodied literature that high-intensity interval training (HIIT) is more effective than
      moderate-intensity continuous training (MICT) at improving markers of cardiometabolic health.
      Before we can understand the long-term training effects of HIIT in this population, it is
      important to compare the acute metabolic responses to a typical mixed-macronutrient meal
      following both exercise modalities.

      This study is recruiting adults (aged 18-65 years) with paraplegia (T2 or below) who
      sustained their spinal cord injury more than one-year ago. Participants will need to attend
      the laboratory at the University of Bath on four separate occasions, once for preliminary
      testing, and three times for study trials.
    

Detailed description: 
      The aim of this research is to determine the metabolic responses to a mixed-meal tolerance
      test following a bout of HIIT and MICT in persons with chronic paraplegia. The hypothesis is
      that HIIT and MICT will be more effective at reducing the total triglyceride responses
      compared to a resting control condition.

      Preliminary measurements:

      Preliminary testing will include anthropometric measurements of supine length, weight, waist
      and hip circumferences, and resting blood pressure. There will also be an assessment of
      resting metabolic rate, sub-maximal and maximal exercise capacity, and a HIIT familiarisation
      session. All of the exercise protocols will take place on an arm crank ergometer at the
      University of Bath.

      Physical activity monitoring:

      For 7 days, participants will be fitted with a physical activity monitor (Actiheart™).
      Participants should not make any conscious changes to their normal lifestyle habits/routines
      during this period.

      Main trial days:

      In the 2 days prior to the main trial day, participants will be asked to record their food
      and drink intake and 48 hours before they should refrain from performing any strenuous
      physical activity. In the 24 hours prior participants should also refrain from consuming any
      alcohol or caffeine.

      Following a 10-hour overnight fast, an expired gas sample and venepuncture blood sample will
      be taken prior to exercise. Participants will then perform a bout of HIIT, MICT or a resting
      control condition. Following exercise, a cannula will be inserted into a vein and baseline
      blood sample(s) taken for analysis of metabolic markers.

      The participant will then be asked to consume a smoothie, consisting of peanut butter,
      banana, coconut oil, sugar, and chocolate-flavoured whey protein powder. The meal should be
      consumed within 10 minutes and blood samples will be taken from the cannula at 15, 30, 45 60,
      and 90 minutes and then at every hour for 6 hours after consumption of the meal to monitor
      changes in metabolic and inflammatory markers. Expired gas samples will also be taken hourly
      and indirect calorimetry will be used to estimate relative fat and carbohydrate metabolism in
      response to the meal.
    

Intervention name(s): Exercise
Intervention type(s): Other
Intervention description(s): Arm-cranking exercise
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Basic Science
Keywords: high-intensity interval training; postprandial metabolism