Sprint Interval Training for Spinal Cord Injury

(SIT Trial)

Overseen By Aaron Flaster

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Washington

Disqualifiers: Poorly controlled diabetes, Unstable cardiovascular, Shoulder injury, others

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

Compensation: Varies

Number of Visits: 10

32 Participants Needed

Trial Summary

What is the purpose of this trial?

This study will assess the feasibility and efficacy of 3 treatments to increase physical activity during and after inpatient rehabilitation (IPR) for new spinal cord injuries: 1. Program of sprint interval training (SIT) on an arm crank ergometer during IPR 2. SIT + Provision of an arm ergometer (ERGO) for home use 3. SIT + ERGO for home use + Motivational interviewing to increase adherence to exercise during and after IPR. The primary outcome is minutes per week of moderate to vigorous physical activity at 6 months after IPR discharge. Secondary outcomes include peak power on the 6-Minute Arm Test at IPR discharge and self-reported physical activity, depression, fatigue, pain, community participation, and quality of life at 6 months after IPR discharge. The investigators will obtain data on feasibility, acceptability, and perceived benefits of the treatments from stakeholders. The results of this pilot study will inform the design of a larger randomized trial.

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's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Home Ergometer (ERGO), Motivational Interviewing (MI), Sprint Interval Training (SIT) for spinal cord injury?

Research shows that regular interval training on a seated ergometer can safely increase physical capacity in individuals with spinal cord injury, suggesting that similar methods like Sprint Interval Training (SIT) could be effective. Additionally, long-term exercise training has been shown to improve strength and psychological well-being in people with spinal cord injury, supporting the potential benefits of this treatment approach. ^{1 2 3 4 5}

Is Sprint Interval Training safe for people with spinal cord injuries?

The studies reviewed focus on high-intensity interval training (HIIT) for people with spinal cord injuries, assessing its feasibility and health benefits. While they do not specifically address safety, the research implies that HIIT, which includes sprint interval training, is being actively studied for this population, suggesting a level of safety that allows for such trials. ^{6 7 8 9 10}

How does Sprint Interval Training (SIT) differ from other treatments for spinal cord injury?

Sprint Interval Training (SIT) is unique because it involves short bursts of high-intensity exercise that can improve both aerobic and anaerobic performance, which is different from traditional rehabilitation exercises that may focus more on steady, moderate activity. This approach can enhance peak speed and oxygen uptake, offering a novel way to potentially improve physical capacity in individuals with spinal cord injury. ^{11 12 13 14 15}

Research Team

Deborah A Crane, MD, MPH

Principal Investigator

University of Washington

Eligibility Criteria

Adults aged 18-65 with a new spinal cord injury (SCI) below the C2 vertebra, classified as AIS A-C, who are currently in acute inpatient rehabilitation at Harborview Medical Center and can use an arm ergometer. Excluded are those with shoulder injuries, other conditions preventing safe participation, uncontrolled diabetes type II, or unstable heart disease.

Inclusion Criteria

My spinal cord injury is classified between AIS A to C.

My spinal cord injury is below the second neck vertebra.

I am currently in acute inpatient rehab for spinal cord injury at Harborview.

Exclusion Criteria

I have a heart condition that changes or gets worse quickly.

Any other medical condition that would preclude safe participation in study procedures.

My type II diabetes is not well-managed.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Inpatient Rehabilitation

Participants undergo Sprint Interval Training (SIT) approximately three times per week during inpatient rehabilitation

4 weeks

3 sessions per week (in-person)

Post-Discharge Home Exercise

Participants continue SIT at home using a consumer grade ergometer, with motivational interviewing sessions provided monthly

6 months

6 monthly telehealth sessions

Follow-up

Participants are monitored for physical activity and other outcomes at 6 months post-discharge

1 week

1 visit (virtual or in-person)

Treatment Details

Interventions

• Home Ergometer (ERGO)
• Motivational Interviewing (MI)
• Sprint Interval Training (SIT)

Trial Overview The study is testing three approaches to boost physical activity during/after inpatient rehab for SCI: Sprint Interval Training (SIT) on an arm crank ergometer; SIT plus a home-use ergometer; and SIT with the ergometer plus motivational interviews to encourage exercise adherence.

Participant Groups

Group I: Spring Interval Training (SIT) Experimental Treatment 1 Intervention

Participant will take part in SIT approximately three times per week during inpatient rehabilitation.

Group II: SIT + ERGO + MI Experimental Treatment 3 Interventions

Participant will take part in SIT approximately three times per week during inpatient rehabilitation. In addition, participant will be provided with an consumer grade ergometer for home use. The participant will receive Motivational Interviewing sessions with a rehab psychologist one time per week (approximately 4 sessions) during inpatient rehabilitation and one time per month for six months after discharge from the hospital

Group III: SIT + ERGO Experimental Treatment 2 Interventions

Participant will take part in SIT approximately three times per week during inpatient rehabilitation. In addition, participant will be provided with an consumer grade ergometer for home use.

Group IV: Usual Care Active Control 1 Intervention

Participant will take part in the usual care during inpatient rehabilitation

Who Is Running the Clinical Trial?

University of Washington

Lead Sponsor

Trials

1,858

Recruited

2,023,000+

The Craig H. Neilsen Foundation

Collaborator

Trials

62

Recruited

3,100+

Findings from Research

Hybrid High-Intensity Interval Training (HIIT) using Functional Electrical Stimulation (FES) was found to be safe and well-accepted by participants with spinal cord injuries, with no serious adverse events reported during the 8-week study involving 8 participants.

Participants experienced a significant 17% increase in peak oxygen uptake (VO2peak) and reported improvements in leisure time physical activity and quality of life, indicating that this training method can enhance physical fitness and overall well-being for individuals with SCI.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hybrid high-intensity interval training using functional electrical stimulation leg cycling and arm ski ergometer for people with spinal cord injuries: a feasibility study. Vestergaard, M., Jensen, K., Juul-Kristensen, B.[2022]

High-intensity interval training (HIIT) and sprint interval training resulted in higher peak oxygen uptake and heart rates compared to moderate intensity exercise in 9 adults with spinal cord injury, indicating that these interval training methods can effectively enhance cardiorespiratory fitness in this population.

Participants preferred interval training over moderate exercise, suggesting that HIIT may be a more engaging and feasible exercise option for individuals with spinal cord injury, warranting further research into its long-term benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Within-session responses to high-intensity interval training in spinal cord injury. Astorino, TA., Thum, JS.[2022]

A systematic review of 6 studies found no overall difference in time trial (TT) performance improvements between high-intensity interval training (HIIT) and sprint interval training (SIT), indicating both methods are similarly effective for trained individuals.

However, long-duration HIIT (≥ 4 minutes) showed a 2% greater improvement in TT performance compared to SIT, suggesting that longer work intervals may be more beneficial for enhancing performance.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of High-Intensity Interval Training Versus Sprint Interval Training on Time-Trial Performance: A Systematic Review and Meta-analysis. Rosenblat, MA., Perrotta, AS., Thomas, SG.[2021]

References

1. Sweden pubmed.ncbi.nlm.nih.gov

Effects of seated double-poling ergometer training on aerobic and mechanical power in individuals with spinal cord injury. [2014]

2. England pubmed.ncbi.nlm.nih.gov

Changes in spastic muscle tone increase in patients with spinal cord injury using functional electrical stimulation and passive leg movements. [2008]

3. United States pubmed.ncbi.nlm.nih.gov

Effects of circuit resistance training and timely protein supplementation on exercise-induced fat oxidation in tetraplegic adults. [2019]

4. England pubmed.ncbi.nlm.nih.gov

Acute energy cost of multi-modal activity-based therapy in persons with spinal cord injury. [2021]

5. England pubmed.ncbi.nlm.nih.gov

Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being. [2022]

6. England pubmed.ncbi.nlm.nih.gov

Hybrid high-intensity interval training using functional electrical stimulation leg cycling and arm ski ergometer for people with spinal cord injuries: a feasibility study. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Training response to high-intensity interval training in a 42-year-old man with chronic spinal cord injury. [2018]

8. England pubmed.ncbi.nlm.nih.gov

Within-session responses to high-intensity interval training in spinal cord injury. [2022]

9. United States pubmed.ncbi.nlm.nih.gov

At-Home High-Intensity Interval Training for Individuals with Paraplegia Following Spinal Cord Injury: A Pilot Study. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Effect of high-intensity interval training on cardiometabolic component risks in persons with paraplegia: Protocol for a randomized controlled trial. [2022]

11. Germany pubmed.ncbi.nlm.nih.gov

Exercise training comprising of single 20-s cycle sprints does not provide a sufficient stimulus for improving maximal aerobic capacity in sedentary individuals. [2022]

12. Switzerland pubmed.ncbi.nlm.nih.gov

Similar Inflammatory Responses following Sprint Interval Training Performed in Hypoxia and Normoxia. [2020]

13. Canada pubmed.ncbi.nlm.nih.gov

Modified sprint interval training protocols: physiological and psychological responses to 4 weeks of training. [2018]

14. New Zealand pubmed.ncbi.nlm.nih.gov

Effect of High-Intensity Interval Training Versus Sprint Interval Training on Time-Trial Performance: A Systematic Review and Meta-analysis. [2021]

15. Italy pubmed.ncbi.nlm.nih.gov

Effect of sprint interval training load on maximal oxygen uptake in trained men. [2023]