Progressive Resistance Training in Acute Spinal Cord Injury
Spinal Cord Injuries, Quadriplegia, Trauma, Nervous System
About this trial
This is an interventional treatment trial for Spinal Cord Injuries focused on measuring Spinal Cord Injury, Progressive Resistance Training, Physical Therapy, Physiotherapy, Strength Training
Eligibility Criteria
Inclusion Criteria:
- Acquired non-progressive SCI - traumatic, spinal cord stroke, surgical injury
- Within 2 weeks of being identified as medically stable by the treating consultant
- Over 18 years old
- Individuals classified with complete or incomplete tetraplegia (C1-C8), graded A-D according to the American Spinal Injury Association (ASIA) scale
- Bilateral or unilateral partial paresis of at least two muscle groups of the upper limb
- Manual muscle testing grade 2-4 strength in target muscle groups
- Able to tolerate sitting upright in a wheelchair for at least 2 hours
Exclusion Criteria:
- Acute condition impairing a participant's ability to perform PRT (e.g. fracture)
- Proven or suspected neuromuscular weakness affecting the upper limbs due to another condition (e.g. stroke or Guillain-Barré syndrome)
- Unable to follow instructions in English
- Symptomatic cardiac disease
- Ventilator dependency
- Severe spasticity
- Uncontrolled autonomic dysreflexia
- Likely to be discharged before the end of the intervention
Sites / Locations
- Queen Elizabeth University Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
No Intervention
Progressive Resistance Training
Usual care only
The intervention group will receive 8 weeks of Progressive Resistance Training (PRT), twice a week, in addition to usual care. An upper limb functional goal will be identified through discussion with the researcher and the participant. PRT will be individually tailored to target two muscle groups and will be chosen in order to develop strength to progress towards the participants functional goal. The chronic spinal cord injury exercise guideline parameters will be applied (3 sets of 8-10 repetitions, 1-2 mins rest between sets). Participants will be inducted to their PRT programme and will then independently complete the 8 week programme. During each of the following sessions, assistance for set up of equipment and/or limb position will be given by the researcher and/or the participants family, friend or carer, once they have been trained. PRT sessions will be recorded in a diary to monitor sets and repetitions completed, and intensity (visual analogue scale (VAS)).
Participants will continue with their usual care, consistent with standard National Health Service (NHS) care in this population. Usual physiotherapy care is provided, up to 2 times per day, 4 to 5 days per week, each lasting up to 90 minutes. Physiotherapists provide a combination of group exercise and one to one function-orientated physiotherapy sessions to improve balance, general muscle strength, wheelchair and/or transfer skills.