Sprint Interval Training During Rehabilitation After Spinal Cord Injury

Study Overview
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Brief Summary
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Immediately following a spinal cord injury (SCI), patients are admitted to inpatient rehabilitation where they undergo physical reconditioning in preparation for a return to home setting. The current standard of practice for aerobic training is performing arm-ergometry for 25 mins at a frequency of three times per week. Given the move towards shortened length of stay during inpatient rehabilitation, performing MICT can consume a considerable amount of therapy time. Sprint interval training (SIT) has been shown to elicit similar improvements in physical capacity, despite a reduced time commitment to MICT. However, there are no controlled trials comparing the effects of SIT to MICT in individuals with SCI undergoing inpatient rehabilitation. The primary aim of this study was to investigate the efficacy of a five-week, thrice weekly 10 min SIT program and compare outcome measures to a traditional 25 minute MICT program on the arm-ergometer in individuals with SCI undergoing inpatient clinical rehabilitation. It was hypothesized that five weeks of SIT and MICT would induce similar changes in maximal and sub-maximal exercise performance, self-efficacy for exercise, and exercise enjoyment, despite large differences in training volume and time commitment. It was also hypothesized that SIT would be well tolerated and elicit higher levels of cardiovascular strain than MICT.

Official Title
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Sprint Interval Training During Rehabilitation After Spinal Cord Injury

Conditions
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Spinal Cord Injuries, Rehabilitation, Exercise

Intervention / Treatment
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* Other: Sprint interval training
* Other: moderate intensity continuous training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants with sub-acute spinal cord injury (time since injury: 14 - 182 days) Undergoing inpatient rehabilitation Aged 18-65 years Injury level at the second cervical vertebrae (C2) or below Exclusion Criteria: - Unable to perform arm-ergometry training

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants were randomized to one of two groups: (A) sprint interval training (SIT) or (B) moderate intensity continuous training (MICT).
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Moderate Intensity Continuous Training<br>Training was performed three times a week for five weeks. Each session began with a 2 minute warm up, and concluded with a 3 minute cool down. Following the warm-up, participants performed 20 minutes of arm cycling at a self-selected cadence at 45-65% of their peak power output. Total training duration was 25 mins. | Other: moderate intensity continuous training<br>* Participants utilized the arm ergometer for improving aerobic exercise capacity<br>|
| Experimental: Sprint Interval Training<br>The SIT protocol was adopted from Gillen and colleagues (See Ref), and consisted of 3 x 20 second all-out efforts at ≥ 100% of an individuals peak power output. Each sprint was interspersed by 120 seconds of active recovery at 10% of an individuals peak power output. Total training duration was 10 mins. | Other: Sprint interval training<br>* Participants utilized the arm ergometer for improving aerobic exercise capacity<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in peak power output | maximum amount of power produced during a graded exercise test on the arm-ergometer | Change in peak power output from baseline to 5 weeks | 
| Change in sub-maximal arm-ergometry | Participants performed three 5-minute steady state workloads on the arm-ergometer at power outputs corresponding to RPE's of 8, 10 and 12. Participants were given a minimum of 2 minutes, and a maximum of 5 minutes of rest in between each workload. | Change in sub-maximal arm-ergometry from baseline to 5 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Cardiovascular Responses | Monitored heart rate throughout each training session | Throughout each week of training (Week 1,Week 2, Week 3, Week4, Week 5) | 
| Perceptual Responses | Monitored ratings of perceived exertion throughout each training session | Throughout each week of training (Week 1,Week 2, Week 3, Week4, Week 5) | 
| Change in self-efficacy for exercise | Using a self-reported questionnaire, participants rated how confident they are with regards to performing and carrying out regular physical activities and exercises. | Change in self-efficacy from baseline to 5 weeks | 
| Exercise Satisfaction | Participants completed the Physical Activity Enjoyment Scale (PACES) in order to asses the level of enjoyment with the training intervention they received. | Measured only at the end of the intervention (5 weeks) | 
| Pain perceptions | Through a questionnaire, participants rated how much shoulder pain, bodily pain, and physical discomfort they typically experience throughout the day and how much pain they experienced with the intervention they were allocated to. | Measured only at the end of the intervention (5 weeks) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Inpatient Rehabilitation, Sprint interval training, Exercise, Spinal Cord Injury