The effects of hybrid cycle training in inactive people with long-term spinal cord injury: design of a multicenter randomized controlled trial

Abstract

Purpose: Physical activity in people with long-term spinal cord injury (SCI) is important to stay fit and healthy. The purpose of this study is to evaluate the effects of hybrid cycle training (hand cycling in combination with functional electrical stimulation-induced leg cycling) on fitness, physical activity and health among a group of inactive people with long-term SCI.

Method: This study will be a 16-week multicenter randomized controlled trial (RCT) with a 26-week follow-up. Forty inactive people, aged 28–65 years, with paraplegia or tetraplegia for at least 10 years, will be randomly assigned to either an experimental group (hybrid cycle group) or control group (hand cycle group). During 16 weeks, both groups will train twice a week 30 minutes at an intensity of 65–75% of their heart rate reserve. The primary outcome measure is fitness. Secondary outcome measures are physical activity and health-related parameters. The primary and secondary outcome measures will be assessed just before the training program (T1), after 8 weeks of training (T2), directly after (T3), and 26 weeks after the training program (T4).

Conclusion: The results of this RCT may provide future implications for exercise prescription that preserve long-term functioning in people with SCI.

Impications for Rehabilitation

Spinal cord injury (SCI)

• Many people with SCI show a serious inactive lifestyle, associated with deconditioning and secondary health problems, resulting in a reduced participation and quality of life.

• Physical activity in people with SCI is important to avoid this downward spiral that threatens people with SCI.

• Physical activity in people with SCI has traditionally involved upper-body exercise (e.g. hand cycling) due to the lower-limb paralysis.

• Hybrid exercise training (electrical stimulation-induced leg exercise combined with voluntary arm exercise) is expected to be more effective in preventing deconditioning and several secondary health problems (e.g. osteoporosis and cardiovascular disease) compared to arm exercise alone.

Keywords::

• Fitness
• functional electrical stimulation
• hand cycling
• health
• paraplegia
• physical activity
• tetraplegia

Declaration of Interest: This project is part of the Dutch ALLRISC research program and is supported financially by Zon-Mw Rehabilitation program and Fonds NutsOhra, grand no. 89000006.