Energetic Response to Feeding and Exercise in SCI

NCT03545867 | Completed

• 1 other identifier: 20171114
• Study Type: interventional
• Target: 10
• Locations: 1 country
• Sites: 1

Brief Summary

This study investigates the effect of various forms of upper extremity exercise on postprandial glycemia and lipemia in persons with spinal cord injury (SCI). Participants are measured at rest and fed a standardized meal following seated rest (CON), moderate intensity continuous arm cycling (MICT), high intensity interval arm cycling (HIIT), and circuit resistance exercise (CRT) matched for exercise energy expenditure.

Conditions

Spinal Cord Injuries

Keywords

postprandial; glycemia; lipemia; macronutrient metabolism; physical activity

Outcome Measures

Primary Outcomes (2)

• Postprandial insulin sensitivity

  Measured by insulin incremental area under the curve (iAUC).

  2.5 hr

• Postprandial insulin sensitivity

  Measured by "ISIMatsuada" insulin sensitivity index. This index is calculated based on the ratio of blood glucose and insulin.

  2.5 hr

Secondary Outcomes (4)

• Lipemia

  2.5 hr

• Carbohydrate use

  2.5 hr

• Fat use

  2.5 hr

• Fasted insulin sensitivity

  Baseline

Study Arms (4)

Seated control (CON)

EXPERIMENTAL

Participants remain seated in their habitual wheel chair for \~45 min (duration of exercise performed in other arms). Following the intervention they are fed.

Behavioral: Seated control (CON); Other: Liquid Meal

Circuit resistance training (CRT)

EXPERIMENTAL

Participants complete upper extremity resistance maneuvers (lifts) interspersed with low-load/high-speed arm cycling for a combined 30 repetitions of 6 lifts and \~20 min of arm cycling. During this time energy expenditure is measured via open-circuit indirect calorimetry. Following the intervention they are fed.

Behavioral: Circuit resistance training (CRT); Other: Liquid Meal

Moderate intensity continuous (MICT)

EXPERIMENTAL

Participants complete continous arm cycling at a steady-state power output (intensity) matched to the energy expenditure (kcal/min) and duration of exercise (min) response during CRT. Following the intervention they are fed.

Behavioral: Moderate intensity continuous (MICT); Other: Liquid Meal

High intensity interval training (HIIT)

EXPERIMENTAL

Participants complete interval arm cycling at power output that varies between 2 min "active" and two min "recovery" periods. This interval exercise is matched to the total energy expenditure (accumulated kcals) response during CRT. Following the intervention they are fed.

Behavioral: High intensity interval training (HIIT); Other: Liquid Meal

Interventions

Seated control (CON) BEHAVIORAL

Seated rest

Seated control (CON)

Moderate intensity continuous (MICT) BEHAVIORAL

Arm cycling at a continuous power output

Moderate intensity continuous (MICT)

High intensity interval training (HIIT) BEHAVIORAL

Arm cycling at power outputs that vary between high and low intensity intervals

High intensity interval training (HIIT)

Circuit resistance training (CRT) BEHAVIORAL

Alternating between six upper extremity resistance maneuvers interspersed with low-resistance/high-speed arm cycling.

Circuit resistance training (CRT)

Liquid Meal OTHER

A liquid meal consisting of 600 kcal comprised of 50% carbohydrate, 35% fat, and 15% protein (by kcal).

Circuit resistance training (CRT); High intensity interval training (HIIT); Moderate intensity continuous (MICT); Seated control (CON)

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adult (\>/=18 years of age)
• Neurologically stable chronic (\>/= 1year) spinal cord injury (SCI)
• American Spinal Injury Association Impairment Scale (AIS) grade A, B, or C
• SCI at level \</= the first thoracic vertebrae (T1)

You may not qualify if:

• Being of ≤ 18 years of age.
• Contraindication to exercise (ACSM Guideline, 10th edition)
• Lower extremity fracture or dislocation within 6 months of participation,
• History head injury or seizures.
• Inability to consent.
• Restrictions in upper extremity range of motion that would prevent an individual from achieving an unhindered arm cycling motion or moving throughout a range needed to perform resistance maneuvers.
• A pressure ulcer at ischial/gluteus, trochanteric, sacral, or heel sites within the last 3 months.
• Pregnancy determined by urine testing in sexually active females.
• Imprisonment in state or federal jail or prison.

Sponsors & Collaborators

• University of Miami: lead

Study Sites (1)

Lois Pope Life Center

Miami, Florida, 33143, United States

Location

Related Publications (2)

• McMillan DW, Maher JL, Jacobs KA, Mendez AJ, Nash MS, Bilzon JLJ. Effects of Exercise Mode on Postprandial Metabolism in Humans with Chronic Paraplegia. Med Sci Sports Exerc. 2021 Jul 1;53(7):1495-1504. doi: 10.1249/MSS.0000000000002593.

  PMID: 33433151 DERIVED

• McMillan DW, Maher JL, Jacobs KA, Mendez AJ, Nash MS, Bilzon JLJ. Influence of upper-body continuous, resistance or high-intensity interval training (CRIT) on postprandial responses in persons with spinal cord injury: study protocol for a randomised controlled trial. Trials. 2019 Aug 13;20(1):497. doi: 10.1186/s13063-019-3583-1.

  PMID: 31409383 DERIVED

MeSH Terms

Conditions

Spinal Cord Injuries; Hyperlipidemias; Motor Activity

Interventions

High-Intensity Interval Training

Condition Hierarchy (Ancestors)

Spinal Cord Diseases; Central Nervous System Diseases; Nervous System Diseases; Trauma, Nervous System; Wounds and Injuries; Dyslipidemias; Lipid Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Behavior

Intervention Hierarchy (Ancestors)

Physical Conditioning, Human; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Officials

• Mark S Nash, Ph.D.

  University of Miami

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Model Details: Static first arm with randomized remaining three arms.

Study Record Dates

• First Submitted: May 22, 2018
• First Posted: June 4, 2018
• Study Start: February 28, 2018
• Primary Completion: September 30, 2018
• Study Completion: September 30, 2018
• Last Updated: June 19, 2020

Record last verified: 2018-10

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)