Feasibility and acceptability of a home-based arm-crank exercise programme for people living with spinal cord injury
Spinal cord injury
This is a prospective, non-randomised, single-arm feasibility study, informed by prior research, PPIE input, and the multidisciplinary expertise of the study team. The study will evaluate the feasibility of delivering the intervention and levels of participant engagement in 50 individuals with SCI. We will also conduct qualitative interviews and focus groups with participants, individuals excluded due to language or digital barriers, and healthcare professionals to explore the intervention’s acceptability, safety, and practical considerations for future NHS implementation Work package 1. Feasibility study Planned intervention: Home-based ACE programme The proposed intervention is a structured 12-week ACE programme delivered remotely in the participant’s home. After reviewing best practice guidelines highlighted in relevant literature and discussing with our PPIE groups what would be an appropriate commitment for the programme, the intervention volume was set to 30 minutes per day, 3 days per week, for 12 weeks. The programme duration was determined to be in line with a typical community-based exercise programme for health in individuals with SCI. This dose and duration of the intervention allows time for participants to engage in an evidence-based intervention, progress, and see improvement Equipment provision and induction session To support safe and effective participation, all participants will be provided with: 1. A portable arm ergometer (MagneTrainer ER) and an anti-slip mat 2. A chest-worn heart rate HR monitor (Polar H10), a widely used device for monitoring HR in SCI exercise interventions 3. Gripping aids, if needed Each participant will receive a personalised induction session of approximately 45 minutes delivered via Zoom, or in person either in clinic or via a home visit, depending on individual needs and preferences. This session will cover: 1. Introduction to the aims and expectations of the programme 2. Safe setup and positioning of the arm e
1. Aged 16 years and older 2. Diagnosed with cervical, thoracic, or lumbar SCI, and medically stable 3. Can provide informed consent and understand and follow instructions for assessment and intervention 4. Use a wheelchair for >=75% of their waking hours 5. Have sufficient elbow flexors strength to operate an arm-crank ergometer 6. Have access to a device and internet connection capable of running Zoom Due to the scope of this study being a feasibility study, the instructions will be given in English. We are aware of the translation services available in the NHS and will consider this for a future trial for the study to be fully inclusive. Additionally, the inclusion criteria for recruiting stakeholders to the qualitative focus group study are: 1. Aged 18 years and above 2. Qualified specialists for caring patients with spinal cord injury in the NHS SCI care pathways 3. At least 6 months experience in caring for people with SCI
1. Presence of unstable or acute medical conditions that are contraindications for exercise 2. Clinical advice against unsupervised exercise from a consultant or physiotherapist 3. Participation in another research study targeting rehabilitation or health management