Virtual Sport for Adults ≥ 50 Years With Spinal Cord Injury

University Health Network, Toronto

Status: Completed

Conditions: Spinal Cord Injury

Treatments: Other: Virtual group-based handcycling

Study type: Interventional

Funder types: Other

Identifiers

NCT06040749

23-5096

Details and patient eligibility

About

Sport is a physical activity that has many physical, psychological and social benefits for those with spinal cord injury (SCI). However, most sport research involves people with SCI who are <50 years old. This is a problem because many people are >50 years old when first injured. Moreover, people with a SCI are now living longer lives, meaning they also experience more health challenges. Unfortunately, there is limited research studying the impact of sport for adults with SCI aged ≥50 years old.

Full description

Aim: To investigate the impact of sport for people with SCI who are ≥50 years old.

Sport Program: This program will be a trial of virtual handcycling. Fifteen male and five female volunteers who are ≥50 years old, ≥12 months post-SCI, wheelchair users, and medically cleared to exercise will be recruited. Five participants will complete the program at a time, as a group, on Microsoft Teams. The sport program will begin with a physiotherapist virtually leading 15 minutes of warm-up exercises. Next, a person living with SCI who is aged ≥50 years old will facilitate 45 minutes of virtual handcycling while screen sharing an indoor cycling application called Zwift, which will provide participants with visual cues and context for changes in exercise intensity. Participants will be provided a cycle ergometer so they can participate in their own homes, and with a smart watch so heart rate can be monitored. This program will run twice a week for three months.

Outcomes: Data will be collected on physical, psychological, and social health at (1) the start of the sport program, (2) immediately after, and (3) three months after the program ends. Any adverse events experienced will be recorded on a survey. Participants' feedback on the sport program and confidence in staying active will also be assessed using an interview at the end.

Conclusion: The knowledge gained will assist in creating future sport programs that may help address the challenges associated with aging and SCI.

Enrollment: 5 patients

Sex: All

Ages: 50+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Sustained a traumatic or non-progressive, non-traumatic SCI,
2. Chronic stage of recovery (i.e., ≥12 months post-SCI),
3. ≥50 years old,
4. Be a manual wheelchair user,
5. Able to understand spoken English,
6. Can attend two virtual handcycling sessions/week for 12 weeks and attend on-site assessments,
7. Does not intend to change usual physical activity routine throughout duration of the intervention,
8. Be cleared to participate in exercise (determined through completion of the 2022 Physical Activity Readiness Questionnaire for Everyone (PAR-Q+)58),
9. Able to secure hands on handlebars with or without assistance during at-home sessions,
10. Has one emergency contact who can be promptly reached at any point during the intervention,
11. Can independently perform easy-moderate revolutions of arm ergometry movement for ≥10 minutes, with or without adaptations to secure the hands on the handlebars, and
12. Can independently bring up at least one hand to wave at shoulder level.

Exclusion criteria

1. Present with significant shoulder pain that reduces use of upper limbs,
2. Present with condition(s) other than SCI that affect ability to use upper limbs or follow English instructions,
3. Have a pressure injury (>grade 2) on the pelvis, sacrum, or hand(s), or
4. Experienced major trauma or surgery within the last 6 months
5. Have a history of cardiovascular disease (myocardial infarction, stroke, hyperlipidemia or untreated hypertension) and do not receive physician clearance to participate.

Trial design

Primary purpose: Other

Allocation: N/A

Interventional model: Single Group Assignment

Masking: None (Open label)

---

5 participants in 1 patient group

Virtual group-based handcycling

Experimental group

Description:

Virtual group-based handcycling, twice per week for 12 weeks. Each 60-minute session of the intervention will begin with maximum 15 minutes of physiotherapist-led warm-up exercises. Next, a peer-facilitated handcycling session, lasting maximum 45 minutes, will proceed. The handcycling component involves the upper extremities cycling in tandem on a stationary exercise bike. The peer facilitator will be an individual with SCI aged \>50 years, who will co-lead participants alongside the physiotherapist through brief group discussion, maximum 40 minutes of moderate-vigorous handcycling, and maximum 5 minutes of cool-down.

Treatment:

Other: Virtual group-based handcycling