Tele-Exercise for Spinal Cord Injury

Overseen By Emelia Perry, OT,L

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Drexel University

Disqualifiers: Recent hospitalization, Pressure ulcer, Osteoporotic fracture, Vision loss, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 19

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests a virtual exercise program for individuals who have lived with a spinal cord injury (SCI) for at least a year. The goal is to assess the program's impact on mental well-being, self-confidence, and social participation. Participants will attend online exercise classes twice a week for eight weeks, tailored to their physical and emotional needs. This study suits those with SCI who can slightly move their shoulder and have internet access for virtual classes. As an unphased trial, it offers a unique opportunity to contribute to innovative research that could improve the quality of life for those with SCI.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.

What prior data suggests that this tele-exercise program is safe for individuals with spinal cord injury?

Research has shown that exercise programs conducted via video calls are safe and practical for people with spinal cord injuries (SCI). These programs can enhance muscle strength and quality of life without major safety concerns. For instance, participants have responded positively to an 8-week program with sessions twice a week. No serious problems were reported, making it a promising option for those with SCI. Participants generally find the exercises easy and beneficial. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the tele-exercise program for spinal cord injury (SCI) because it offers a unique, accessible approach that differs from traditional rehabilitation therapies, which often require physical presence at a facility. This program is delivered online, making it more convenient and inclusive for individuals with SCI who may face mobility challenges. The classes integrate mind-body practices tailored specifically to the physical and emotional needs of people with SCI, led by professionals and co-led by community members with lived experience. This personalized and community-driven approach could enhance engagement and improve outcomes compared to standard physical therapy.

What evidence suggests that this tele-exercise program is effective for individuals with spinal cord injury?

Research shows that exercise programs conducted through video calls can benefit people with spinal cord injuries (SCI). In this trial, participants in the Group Tele-exercise Class will engage in these programs. Studies have found that such programs can strengthen muscles, enhance physical abilities, and boost confidence in exercising. Participants also reported feeling better overall and becoming more active. A recent study discovered that people with SCI experienced noticeable improvements in their physical abilities and belief in their success after participating in tele-exercise. The evidence suggests these programs can benefit both the body and mind of people with SCI. ^{1 2 4 6 7}

Who Is on the Research Team?

Margaret Finley, PhD

Principal Investigator

Drexel University

Are You a Good Fit for This Trial?

This trial is for adults aged 18-75 with spinal cord injury (SCI) who've lived with the injury for at least a year. They must be able to participate in virtual classes, have some shoulder mobility, and not be in structured rehabilitation. Excluded are those with recent fractures or hospitalization, active pressure ulcers, severe vision loss, or other neurological conditions.

Inclusion Criteria

Living with injury for at least 12 months

My spinal cord injury is classified as ASIA A, B, C, or D.

I can lift my shoulder a little bit.

Exclusion Criteria

Absolute contraindications as identified by ACSM21

Self-report of preexisting neurological conditions other than SCI

Self-report of uncorrectable vision loss

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Pre-Intervention

Participants complete semi-structured interviews or small focus groups and quantitative measures are obtained

1 week

1 visit (virtual)

Tele-exercise Intervention

Participants engage in a group tele-exercise class twice per week for 8 weeks, focusing on mind-body practices tailored to individuals with SCI

8 weeks

16 sessions (virtual)

Post-Intervention Assessment

Participants complete post-intervention measures including leisure time physical activity and quality of life assessments

1 week

1 visit (virtual)

Follow-up

Participants are monitored for retention of physical activity and quality of life improvements

8 weeks

1 visit (virtual)

What Are the Treatments Tested in This Trial?

Interventions

• Group tele-exercise

Trial Overview The study tests an 8-week group tele-exercise program designed to improve physical confidence and strength through virtual classes twice a week. It aims to assess psychological and social benefits using both surveys and interviews before and after the program.

How Is the Trial Designed?

Group I: Waitlist Control Experimental Treatment 1 Intervention

The waitlist control group will complete all quantitative measures as a baseline (baseline-control) and will be instructed to continue their activities as usual, with measures obtained again at 8-weeks (post-control/pre-program). Following the initial 8-week baseline, each waitlist group will participate in pre-intervention semi-structured interview or small focus group with the post-control measures as pre-intervention assessment. They will join the tele-exercise intervention with all measures at 8-weeks (post-intervention) and with leisure time physical activity and quality of life assessed at 16-weeks following initiation of the program.

Group II: Group Tele-exercise Class Experimental Treatment 1 Intervention

Volunteers will be asked to participate in the group online exercise class 2 times per week for 8 weeks. Each activity session will last about 60 minutes and will focus on mind-body practices, tailored to physical and emotional needs of individuals with SCI. Class will be taught by a physical therapist who is an experienced community exercise instructor. Class will be co-led by a person who is living with SCI (one of our community partners). Classes will take place over a secure virtual platform (Zoom). Before beginning and after completion of the program, participants will be asked to participate in small group interviews to share expectations and experiences of the study

Who Is Running the Clinical Trial?

Drexel University

Lead Sponsor

Trials

160

Recruited

48,600+

The Craig H. Neilsen Foundation

Collaborator

Trials

62

Recruited

3,100+

Pennsylvania Department of Health

Collaborator

Trials

42

Recruited

999,000+

Published Research Related to This Trial

Tele-exercise training for individuals with tetraplegia was found to meet the moderate intensity recommendations of spinal cord injury (SCI) exercise guidelines over a 27-week period, indicating its potential as a viable alternative for remote physical training.

The study reported a 45.1% adherence rate to the tele-exercise program, with men showing higher adherence than women, suggesting that while tele-exercise can be beneficial, strategies may be needed to improve participation among all individuals.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does tele-exercise training for tetraplegia meet the spinal cord injury-specific physical activity guidelines? A 7-month longitudinal study. Gomes Costa, RR., Dorneles, JR., Veloso, JHCL., et al.[2023]

In a study involving 40 individuals with spinal cord injury, synchronous tele-exercise programs resulted in significantly higher weekly training loads and better adherence compared to asynchronous programs over a 3-week period.

While both types of tele-exercise had similar average daily workloads, the synchronous approach allowed for more effective implementation, leading to greater overall exercise success and engagement.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Synchronous and asynchronous tele-exercise during the coronavirus disease 2019 pandemic: Comparisons of implementation and training load in individuals with spinal cord injury. Costa, RRG., Dorneles, JR., Veloso, JH., et al.[2023]

A preliminary study involving 4 participants with spinal cord injury showed that an online group-based physical activity program, conducted twice weekly for six weeks, was highly accepted and beneficial for their physical and psychosocial wellbeing.

Participants reported improvements in anxiety and satisfaction with social roles and activities, suggesting that online physical activity programs can be a viable alternative during situations like a pandemic, enhancing overall quality of life for individuals with spinal cord injuries.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feasibility of a virtual service delivery model to support physical activity engagement during the COVID-19 pandemic for those with spinal cord injury. Mehta, S., Ahrens, J., Abu-Jurji, Z., et al.[2022]

A 12-week high-dose home exercise program for manual wheelchair users with spinal cord injury significantly reduced shoulder pain and improved function, as measured by various pain and function indices.

Participants showed increased strength in specific shoulder muscles after the intervention, indicating that telerehabilitation can effectively support rehabilitation efforts for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of home exercise on pain, function, and strength of manual wheelchair users with spinal cord injury: a high-dose shoulder program with telerehabilitation. Van Straaten, MG., Cloud, BA., Morrow, MM., et al.[2022]

Telerehabilitation showed a significant improvement in functional scores for patients with spinal cord injury at the Italian site, with the telemedicine group achieving better results in activities like grooming and dressing compared to standard care.

Patients receiving telerehabilitation reported higher satisfaction with their care across all sites, suggesting that this approach may enhance the overall patient experience post-discharge.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Functional and clinical outcomes of telemedicine in patients with spinal cord injury. Dallolio, L., Menarini, M., China, S., et al.[2019]

A 2-month synchronous group tele-exercise program for individuals with spinal cord injury (SCI) was found to be feasible, with 100% retention and an average attendance of 10 out of 16 classes per participant.

Participants reported increased exercise knowledge, confidence, and motivation, highlighting the importance of having instructors with SCI-specific knowledge and a supportive group structure in facilitating participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development and Feasibility of a Group Tele-Exercise Program for Individuals With Spinal Cord Injury. Baehr, LA., Kaimal, G., Bruneau, M., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12004304/

Tele-exercise in individuals with spinal cord injury Tele-exercise interventions are effective and feasible for individuals with spinal cord injury (SCI). These interventions often emphasize muscle strength and ...

2. tandfonline.com tandfonline.com/doi/full/10.1080/10790268.2025.2524225

Tele-exercise and spinal cord injury: Effects on physical ... Objective: To assess strength, physical activity levels, and quality of life in people with SCI following a synchronous tele-exercise program.

3. archives-pmr.org archives-pmr.org/article/S0003-9993(23)00512-9/fulltext

Effect of Tele-exercise to Promote Empowered Movement ... A recent randomized controlled trial found that participants with SCI reported significantly improved physical function, exercise self-efficacy, ...

4. centerwatch.com centerwatch.com/clinical-trials/listings/NCT05360719/integrated-tele-exercise-for-individuals-with-spinal-cord-injury

Integrated Tele-exercise for Individuals With Spinal Cord ... The objective of this study is to examine the efficacy of an integrated, participant-centered tele-health physical activity program for ...

5. pubs.sciepub.com pubs.sciepub.com/jpar/7/1/3/index.html

Group Tele-exercise for Individuals with Spinal Cord Injury This pilot study used a mixed methods approach to determine outcomes of a group tele-exercise program to promote physical and psychosocial well-being.

6. sciencedirect.com sciencedirect.com/science/article/pii/S2590109525000709

Interim Analysis of the Spinal Cord Injury Program ... The Spinal Cord Injury Program in Exercise (SCIPE) study aimed to investigate two 8-week teleexercise interventions in adults with SCI, Movement ...

7. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/37306469/

Development and Feasibility of a Group Tele-Exercise ... The purpose of this study was to evaluate the feasibility of a synchronous group tele-exercise program designed for individuals with SCI.