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Spinal Cord InjuriesSMART-HEALTHNCT04726891

Feasibility of the First Known Adaptive Intervention for People With SCI

A study testing Movement-2-Music + Social Networking Support in people with Spinal Cord Injuries, run by University of Alabama at Birmingham at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The overall goal of the proposed research is to conduct a pilot study to test the feasibility and acceptability of a home-based exercise intervention (SMART-HEALTH). The primary purpose of the pilot study is to assess the feasibility of intervention delivery (Aim 1), the acceptability of the intervention by… Read more about this study

Who is it for?
Ages 18 to 71 yearsHealthy volunteers can take part
Conditions the study is for
Spinal Cord Injuries
What is being tested?
Movement-2-Music + Social Networking Support
Could I receive a placebo?
No, everyone receives an active treatment
How many people
36 participants
Where
1 siteUnited States
Study dates
26 Jun 2022to 15 Oct 2023
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 71 years
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • SCI greater than or equal to 1 year after injury
  • Wheelchair User
  • Able to use arms for exercise
  • 18+ years old
  • Sedentary (<60 minutes of exercise/week)

Who cannot join

  • Cognitive Impairment (Folstein's Mini-Mental State Exam Score < 24)
  • Depression (Centers for Epidemiological Studies Depression Scale Score > 16)
  • Poorly controlled blood pressure (SBP > 159 or DBP > 95 mmHg)
  • Cardiovascular disease event within the past 6 months, severe pulmonary disease, kidney failure
  • Active pressure ulcers

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Lakeshore Foundation

    Birmingham, Alabama, 35209

Other trials in United States

About this study

Official title: Feasibility of the First Known Adaptive Intervention Delivering Innovative Exercise Program Optimized for People With SCI

The overall goal of the proposed research is to conduct a pilot study to test the feasibility and acceptability of a home-based exercise intervention (SMART-HEALTH). The primary purpose of the pilot study is to assess the feasibility of intervention delivery (Aim 1), the acceptability of the intervention by participants (Aim 2) and estimate effect sizes for a future trial (Aim 3).

Read the detailed description

The proposed project aims to address low adherence to exercise interventions among people with SCI. Specifically, we will conduct a 12-week pilot study of a SMART design using a telehealth-delivered intervention previously developed for people with mobility disability as the primary intervention strategy. This intervention, Movement-to-Music (M2M), has been previously packaged as a collection of videos disseminated through an app on a weekly schedule. M2M has been shown to effectively improve physiological outcomes among people with a neurological disability, including SCI. Data collection will include accelerometer-based measurement of physical activity and sleep during the intervention, a 3-day physical activity recall, and assessment of physiological (e.g., grip strength) and psychosocial factors (i.e., depression, anxiety) collected before and after intervention. Social Cognitive Theory has been used successfully in past studies to improve many health behaviors. Thus, it will be utilized into SMART-HEALTH as the following constructs: self-efficacy, self-regulation, social support, and outcome expectations.

A sample of individuals with SCI will be randomized to 3 weeks or 6 weeks of M2M with social networking support for the first treatment stage. Depending on adherence, they will either continue with the intervention received in the first treatment stage or be randomized a second time. Specifically, participants with high adherence (40 or more minutes) will continue M2M with social networking support, while those with low adherence (less than 40 minutes) will be randomized to an augmented arm that includes individualized behavioral coaching or to an arm that switches to M2M Live. The second treatment stage will last until the participant has completed a total of 12 weeks on the program. The social networking support, individualized behavioral coaching, and M2M Live sessions will be completed through secure videoconferencing on the mobile health platform, which will allow a singular location for tracking intervention activity. All security features of the integrated videoconferencing software will be used, including passwords and waiting rooms.

M2M. In the first treatment stage, all participants will receive M2M as the evidence-based home exercise intervention. M2M is provided in the form of an exercise routine that includes aerobic and strength training set to music. Each week the participants will receive a set of exercise videos, which they will be asked to complete 3 times during the week. Exercise videos begin with a low dose of minutes, approximately 10 to 15 minutes for a total of 40 minutes for the week, and increase by 3-5 minutes each week.

Social Networking Support. In the first treatment stage, all participants will also receive social networking support. The group will also be able to communicate through the mobile health platform via features such as messaging, posting, commenting, and liking. Each week a discussion board will provide an opportunity for participants to post comments concerning the week's exercise content, weekly article, and/or their experience with the program that week.

Individual Behavioral Coaching. Some participants with sub-optimal adherence in the first treatment stage will be randomized to one of two treatment groups in the second treatment stage. Half of these participants will receive M2M plus social networking support augmented with individualized behavioral coaching.

M2M Live. The remaining half of participants with sub-optimal adherence in the first treatment stage will switch to another M2M-based home exercise intervention, M2M Live. This involves one-on-one tele-exercise training with an M2M instructor. During the first week of M2M Live, the participant will set a schedule to meet with the M2M instructor one time per week for an exercise session. The exercise session will be recorded and posted for the participant to complete 2 additional times.

Being tested
Movement-2-Music + Social Networking Support
Keywords
exercise, behavioral coaching
Medical subject headings
Spinal Cord Injuries, Motor Activity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Movement-2-Music + Social Networking SupportBehavioural

    Also called Individual Behavioral Coaching; Movement-2-Music Live

    The primary goal of the proposed research is to conduct a 12-week pilot study of the SMART-HEALTH intervention in 30 individuals with SCI. There are several unique features of this study design, including a novel adapted exercise program (M2M), instructor-led, individualized training (M2M Live; described in D.2.1), individualized behavioral coaching, and social networking support.

Study groups in NCT04726891
Study groupRoleWhat they receive
Continued M2M + SNS for 9 weeksActive comparatorParticipants who successfully watch and exercise at or above 40 minutes per week will continue doing M2M + SNS for the remaining 9 weeks of the study.
Receives: Behavioral: Movement-2-Music + Social Networking Support
Augmented M2M + SNS + IBC for 9 weeksActive comparatorSome participants with sub-optimal adherence in the first treatment stage will be randomized to one of two treatment groups in the second treatment stage. these participants will receive M2M plus social networking support augmented with individualized behavioral coaching. Individualized behavioral coaching involves a weekly coaching session to improve self-regulatory skills based on prior and individualized exercise prescription. The exercise prescriptions are determined by the coach and individual based on their current activity level and a 4-week goal. An example of tailoring the exercise prescribed involves setting a goal of completing the exercise routine one time for the upcoming week instead of three times. The coach will be trained in motivational interviewing to help the participant modify their exercise habits.
Receives: Behavioral: Movement-2-Music + Social Networking Support
Switched M2M Live for 9 weeksActive comparatorThe remaining half of participants with sub-optimal adherence in the first treatment stage will switch to another M2M-based home exercise intervention, M2M Live. M2M Live involves one-on-one tele-exercise training with an M2M instructor, which provides accountability and immediate, tailored feedback along with custom movements and music. During the first week of M2M Live, the participant will set a schedule to meet with the M2M instructor 1 time each week for an exercise session. The M2M Live instructors are also trained in motivational interviewing in order to coach participants through any barriers to changing their exercise behavior.
Receives: Behavioral: Movement-2-Music + Social Networking Support
Continued M2M + IBC for 6 weeksActive comparatorParticipants who successfully watch and exercise at or above 40 minutes per week will continue doing M2M + SNS for the remaining 6 weeks of the study.
Receives: Behavioral: Movement-2-Music + Social Networking Support
Augmented M2M + SNS + IBC for 6 weeksActive comparatorSome participants with sub-optimal adherence in the first treatment stage will be randomized to one of two treatment groups in the second treatment stage. these participants will receive M2M plus social networking support augmented with individualized behavioral coaching. Individualized behavioral coaching involves a weekly coaching session to improve self-regulatory skills based on prior and individualized exercise prescription. The exercise prescriptions are determined by the coach and individual based on their current activity level and a 4-week goal. An example of tailoring the exercise prescribed involves setting a goal of completing the exercise routine one time for the upcoming week instead of three times. The coach will be trained in motivational interviewing to help the participant modify their exercise habits.
Receives: Behavioral: Movement-2-Music + Social Networking Support
Switched M2M Live for 6 weeksActive comparatorThe remaining half of participants with sub-optimal adherence in the first treatment stage will switch to another M2M-based home exercise intervention, M2M Live. M2M Live involves one-on-one tele-exercise training with an M2M instructor, which provides accountability and immediate, tailored feedback along with custom movements and music. During the first week of M2M Live, the participant will set a schedule to meet with the M2M instructor 1 time each week for an exercise session. The M2M Live instructors are also trained in motivational interviewing in order to coach participants through any barriers to changing their exercise behavior.
Receives: Behavioral: Movement-2-Music + Social Networking Support

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Physical Activity

    Physical Activity Recall Among people with Spinal Cord Injury (PARA-SCI) Instrument will be used to assess minutes of physical activity. Designed to estimate 3-day summary values for physical activity, including intensity (mild, moderate, or vigorous), duration, and modality (aerobic or strength training), which results in providing total minutes of moderate to vigorous physical activity. The higher number of minutes the better.

    Measured: baseline, 4-weeks, 8-weeks, and 12 weeks

Secondary outcomes (11)
  1. Strength

    Grip strength

    Measured: baseline and 12 weeks

  2. Respiratory functioning

    Peak Expiratory Volume measured by spirometer

    Measured: baseline and 12 weeks

  3. Blood pressure

    Two readings prior to exercise using digital blood pressure cuff.

    Measured: baseline and 12 weeks

  4. Heart rate

    Two readings prior to exercise using digital blood pressure cuff.

    Measured: baseline and 12 weeks

  5. Physical activity self-efficacy scale

    Survey of social cognitive theory construct.

    Measured: baseline and 12 weeks

  6. Outcomes expectations for exercise scale

    Survey of social cognitive theory construct.

    Measured: baseline and 12 weeks

  7. demographics

    questionnaire including age, sex, race, ethnicity

    Measured: baseline and 12 weeks

  8. sleep disturbance

    Secondary health conditions NIH PROMIS

    Measured: baseline and 12 weeks

  9. Depression

    Secondary health conditions NIH PROMIS

    Measured: baseline and 12 weeks

  10. Pain intensity

    Secondary health conditions NIH PROMIS

    Measured: baseline and 12 weeks

  11. Anxiety

    Secondary health conditions NIH PROMIS

    Measured: baseline and 12 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted27 Jan 2021
  2. Study start26 Jun 2022
  3. Primary completion1 Oct 2023
  4. Study completion15 Oct 2023

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Prevention
Allocation
Randomised
Intervention model
Factorial
Model description
sequential multiple assignment randomized trial
Masking
Triple blind
Who is masked
Participant, Investigator, Outcomes assessor
Enrolment
36 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04726891
Sponsor's protocol ID
645335
Other IDs
645335
Acronym
SMART-HEALTH
Status last verified
Jul 2024
First submitted
21 Jan 2021
Last updated
15 Jul 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No

Publications

  • Wilroy J, Kim Y, Lai B, Young HJ, Giannone J, Powell D, Thirumalai M, Mehta T, Rimmer J. Increasing Physical Activity in Persons With Spinal Cord Injury With an eHealth-Based Adaptive Exercise Intervention: Protocol for a Sequential Multiple Assignment Randomized Trial. JMIR Res Protoc. 2023 Jul 27;12:e47665. doi: 10.2196/47665.

    PubMed 37498650

Questions about this trial

What is this clinical trial studying?

A study testing Movement-2-Music + Social Networking Support in people with Spinal Cord Injuries, run by University of Alabama at Birmingham at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Jul 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Physical Activity (time frame: baseline, 4-weeks, 8-weeks, and 12 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04726891, which also lists 1 linked publication.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Jul 2024.

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