Therapeutic Lifestyle Intervention Targeting Enhanced Cardiometabolic Health and Function for Persons with Chronic Spinal Cord Injury in Caregiver/Care-Receiver Co-Treatment : A Study Protocol of a Multisite Randomized Controlled Trial

BACKGROUND: Chronic spinal cord injury (SCI) significantly accelerates morbidity and mortality, partly due to the increased risk of cardiometabolic diseases (CMD), including neurogenic obesity, dyslipidemia, and impaired glucose metabolism. While exercise and dietary interventions have shown some transient benefits in reducing CMD risk, they often fail to improve clinically relevant disease markers and cardiovascular events. Moreover, SCI also places caregiving demands on their caregivers, who themselves experience health and functional decline. This underscores the need for more substantial interventions that incorporate appropriate physical activity, heart-healthy nutrition, and behavioral support tailored to the SCI population.

OBJECTIVES: This randomized clinical trial (RCT) protocol will (1) assess the health and functional effects, user acceptance, and satisfaction of a 6-month comprehensive therapeutic lifestyle intervention (TLI) adapted from the National Diabetes Prevention Program (DPP) for individuals with chronic SCI and (2) examine the impact of a complementary caregiver program on the health and function of SCI caregivers and evaluate user acceptance and satisfaction. Caregivers (linked with their partners) will be randomized to 'behavioral support' or 'control condition'.

METHODS: Dyadic couples comprise individuals with SCI (18-65 years, >1-year post-injury, ASIA Impairment Scale A-C, injury levels C5-L1) and non-disabled SCI caregivers (18-65 years). Both groups undergo lock-step circuit resistance training, a calorie-restricted Mediterranean-style diet, and 16 educational sessions focused on diet/exercise goals, self-monitoring, psychological and social challenges, cognitive behavioral therapy, and motivational interviewing. The outcome measures encompass the cardiometabolic risks, cardiorespiratory fitness, inflammatory stress, multidimensional function, pain, life quality, independence, self-efficacy, program acceptance, and life satisfaction for SCI participants. The caregiver outcomes include multidimensional function, pain, quality of life, independence, and perceived caregiver burden.

DISCUSSION/CONCLUSIONS: This study evaluates the effects and durability of a structured, multi-modal intervention on health and function. The results and intervention material will be disseminated to professionals and consumers for broader implementation.

TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT02853149 Registered 2 August 2016.

Medienart:

E-Artikel

Erscheinungsjahr:

2023

Erschienen:

2023

Enthalten in:

Zur Gesamtaufnahme - volume:20

Enthalten in:

International journal of environmental research and public health - 20(2023), 19 vom: 25. Sept.

Sprache:

Englisch

Beteiligte Personen:

Bigford, Gregory E [VerfasserIn]
Betancourt, Luisa F [VerfasserIn]
Charlifue, Susan [VerfasserIn]
Nash, Mark S [VerfasserIn]

Links:

Volltext

Themen:

Behavioral modification
Cardiometabolic disease
Clinical Trial Protocol
Exercise
Intervention
Journal Article
Metabolism
Nutrition
Rehabilitation
Research Support, U.S. Gov't, Non-P.H.S.
SCI

Anmerkungen:

Date Completed 01.11.2023

Date Revised 01.11.2023

published: Electronic

ClinicalTrials.gov: NCT02853149

Citation Status MEDLINE

doi:

10.3390/ijerph20196819

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM363280561