Effects of Spinal Cord Injury Exercise Guidelines
Chronic Pain, Spinal Cord Injuries
About this trial
This is an interventional treatment trial for Chronic Pain
Eligibility Criteria
Inclusion Criteria:
- (i) adults aged >18 with an spinal cord injury (SCI), traumatic or non-traumatic cause;
- (ii) ASIA impairment scale classifications A-D, injury levels C3 or below;
- (iii) >12 mos post-injury [criteria i-iii capture the group to whom the SCI Exercise Guidelines apply);
- (iv) reporting chronic pain, defined as pain that persists or recurs for more than 3 mos on a question taken from the US Model SCI Systems measures: ["Using a 0 to 10 scale with 10 being pain so severe you could not stand it and 0 being no pain, what has been the usual level of pain over the past 3 months?"] and scoring at or above 1;
- (v) report pain secondary to SCI that is classified as neuropathic and/or musculoskeletal (MSK) using theInternational SCI Pain Basic Data Set (v2.0) pain descriptions. [The trial physiatrist will train the research coordinators to use the Data Set and will make final decisions on unclear cases.];
- (vi) report <40 min/wk of structured, moderate intensity, aerobic exercise and <2 bouts/week of strength training (i.e. less than the Starting Level guideline) on a modified version of the Leisure Time Physical Activity Questionnaire-SCI (<15% of Canadians with SCI currently achieve the Starting Level so the trial can assess the effects of increasing exercise to recommended levels;
- (vii) no medical contra-indications to performing a maximal exercise test;
- (viii) have access to a phone.
Exclusion Criteria:
- (i) chronic pain with exclusively non-MSK or non-neuropathic origins (e.g. headache, abdominal pain-because the effects of exercise on these pain types are unknown);
- (ii) insufficient diaphragmatic control and arm functioning to do upper-body exercise;
- (iii) live beyond driving distance of the research site;
- (iv) insufficient English language proficiency to complete questionnaires and converse with the fitness trainer and counselor;
- (v) have been previously told s/he has a cognitive or memory impairment;
- (vi) pregnant (because safety of the guidelines are unknown);
- (vii) hospital in-patient at the time of enrolment.
Sites / Locations
- University of British ColumbiaRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Exercise Condition
Wait-list Control
The intervention is a personalized exercise prescription based on the International Scientific Spinal Cord Injury (SCI) Exercise Guidelines. Participants begin at the Starting Level guideline: 20 min aerobic exercise, 2x/wk, at 70% of heart rate reserve (or a Borg Continuous Ratio 0-10 rating of 6), & 3 sets of 10 repetitions of strengthening exercises (each major functioning muscle group at 50-80% of 1-rep max), 2x/wk. Participants will gradually increase aerobic exercise to 30 min, 3x/wk (i.e. the Advanced Level guideline). Exercise implementation will be supported by a fitness trainer and an exercise counsellor with SCI-specific training and experience.
Control participants will not get an exercise prescription. They will be asked to refrain from lifestyle changes for 6 mos. After the 6-month waitlist period, Controls will receive the same resources as Exercisers.