Blood Flow Restriction Resistance Exercise in Lower Cervical Spinal Cord Injury Patients

Study Overview
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Brief Summary
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This study is conducted to investigate the effects of low load Blood Flow Resistance exercise to improve strength and transfer in lower cervical spinal cord injury patientsCervical Spinal Cord injury patients have very less window of opportunity towards functional mode of life. In complete cervical spinal cord injuries only few muscles of upper limb are completely innervated and it is a need to gain maximum output and advantage out of that. Through conventional strength training it is possible to make him do unsupported sitting and transfer But with BFR-RE it may have a possibility to do this procedure in less time than the conventional strength training and patient will save cost of hospital stay as he may timely discharge from hospital early

Official Title
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Effects of Blood Flow Restriction Resistance Exercise on Strength and Transfer in Lower Cervical Spinal Cord Injury Patients

Conditions
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Cervical Spinal Cord Injury

Intervention / Treatment
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* Other: Blood flow restriction
* Other: Conventional physical therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both male and female, with age between 16-50 years. Patients evaluated with C6 to C8 tetraplegic complete injury. Patients classified in ASIA A, ASIA B. At least Muscle grading of grade 2. Patients with sub-acute, chronic stage. Exclusion Criteria: Patients with other neurologic conditions, orthopedic problems, and uncontrolled metabolic diseases. Patients with muscles strength grading of less than 2. Undergone nerve transfer surgery. Patients with acute stage. History of DVT. Patients who are already performing structured physical activities such as muscle Strengthening exercises.

Ages Eligible for Study
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Minimum Age: 15 Years
Maximum Age: 50 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: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Blood flow restriction<br>Resistance training protocol but with Blood flow restriction technique Standard BFR Application: a standard pressure (used for all patients) for e.g. 180 mmHg; a pressure relative to the patient's systolic blood pressure, for e.g. 1.2 - or 1.5-fold greater than systolic blood pressure. | Other: Blood flow restriction<br>* strengthening protocol but with Blood flow restriction technique .Standard BFR Application: a standard pressure (used for all patients) for e.g. 180 mmHg; a pressure relative to the patient's systolic blood pressure, for e.g. 1.2 - or 1.5-fold greater than systolic blood pressure.40% cuff pressure as percentage of LOP.(4) And performing BFR-RE with low load exercises. So 30% of 1 RPM would be enough 4 times a week for 6 week<br>|
| Active Comparator: Conventional physical therapy<br>Resistance training to stimulate skeletal muscle hypertrophy and strength adaptations in Duration of 6 weeks | Other: Conventional physical therapy<br>* Resistance exercise 75 repetitions across four sets of exercises, with30 repetitions in the first set and 15 repetitions in each subsequent set. 4 times a week for 6<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| VAS- Visual Analogue Scale | To measure the intensity of pain | 6th week | 
| MAS- Modified Ashworth Scale | To measure the muscular hypertrophy and increased tone. Usually used to measure increased tone in spasticity but also used to measure hypertrophy resulted from normal muscles adaptations. | 6th week | 
| QIF-SF -- Quadriplegia Index Of Functionality-Small Form | To the transfer and functional ability in tetraplegic patients. | 6th week | 
| Hand Held Dynamometer | To measure the strength objectively and To measure the minor but notable changes in strength change which cannot be detected by MMT | 6th week |