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NCT Number: NCT06905470

The Effects of Eccentric Compared to Standard Strength Training in Primary Spinal Cord Injury Rehabilitation

The goal of this clinical trial is to assess the effects of eccentric arm-crank (KREHA) training compared to standard clinical routine strength (STAN) training in individuals undergoing primary spinal cord injury (SCI) rehabilitation.

The main questions this trail aims to answer are:

* what are the effects of the training on upper body strength, aerobic performance, muscle volume, functional independence, and health-related quality of life? * is the KREHA training feasible to implement into the rehabilitation routine?

Participants will:

* perform either 20 KREHA sessions or 20 STAN sessions within 12 weeks * perform a test battery to collect data on training effects before (pretest) and after (posttest) the study intervention

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Key information

Conditions

Spinal Cord Injury Central Nervous System Diseases Nervous System Diseases Spinal Cord Diseases Spinal Cord Injuries Trauma, Nervous System Wounds and Injuries

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Swiss Paraplegic Centre

Nottwil, Canton of Lucerne, 6207, Switzerland

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • 18 years or older.
  • informed consent as confirmed per signature.
  • traumatic or disease-related SCI.
  • participating in the routine strength training program during primary SCI rehabilitation at the study center (generally this is initiated around one month after SCI onset).
  • wheelchair dependency during activities of daily living, defined by a score of 0-2 in the SCIM subsection regarding "Mobility in the house".
  • passed sports medical assessment and having sufficient biceps/triceps function to perform arm-crank training, as determined by an experienced sports medicine physician

Exclusion criteria

  • inflammatory or neurodegenerative diseases (including multiple sclerosis or Guillain-Barré syndrome).
  • comorbidities or other health issues that may interfere with study participation, inability or contraindications to undergo the investigated intervention.
  • MRI contraindications (magnetic metal parts or electronic implants such as pacemakers in the body).
  • pregnancy (anamnestic).

Treatment and study plan

Eccentric (KREHA) training

Procedure

20 eccentric resistance training sessions will be performed on a symmetric arm-crank ergometer in a supine position.

Standard clinical routine strength (STAN) training

Procedure

The regular strength training intervention consists of a total of 20 training sessions at the gym of the study center, performed following clinical routine procedures.

Primary outcomes

  1. Upper body strength

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Change in upper body strength will be measured by a one-repetition maximum (1RM) bench press (in kg). The maximum amount of weight that can be pushed upwards for one repetition, while lying in a supine position on a weight training bench.

Secondary outcomes

  1. Upper body strength

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Change in upper body strength measured by a 1RM bench pull (in kg). The maximum amount of weight that can be pulled upwards for one repetition, while lying in a prone position on a weight training bench.

  2. Handgrip strength

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Change in maximum strength of three handgrip measurements (in kg) of both hands using a Jamar Handgrip Dynamometer.

  3. Aerobic performance

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Change in cardiopulmonary adaptations, measured by aerobic performance in an exercise test on a regular arm-crank ergometer. A ramp protocol starting at 20 Watt followed by 1 Watt / 6 sec increments to failure will be used. The following parameters will be evaluated during this aerobic endurance test: power at failure at the end of the test (in Watt), peak oxygen uptake during the test (in ml/kg/min), maximal heart rate (bpm)

  4. Muscle volume

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Magnetic resonance imaging (MRI) of relevant upper body muscles of the dominant upper arm and shoulder will be used to measure change in muscle volume.

  5. Arm circumference

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Change in arm circumference of the right and left lower and upper arm (in cm), will be used to estimate muscle volume.

  6. Functioning during activities of daily living

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Change in functioning during activities of daily living will be assessed by the Spinal Cord Independence Measure (SCIM) as extracted from clinical records. The SCIM total score ranges from 0-100, with higher scores indicating higher levels of functional independence.

  7. Health-related quality of life

    Time frame: < 1 week pre and 12 weeks post intervention start.

    Change in health-related quality of life will be assessed using the Short Form Health Survey (SF-12). Weighted physical and mental component scores range from 0-100, with higher scores indicating better physical or mental health.

Other outcomes

  1. Feasibility of the KREHA training (total number of training sessions)

    Time frame: Throughout the intervention phase, week 0-12

    Successful implementation of the KREHA training in the clinical routine, by assessing whether the 20 KREHA sessions are completed within 12 weeks.

  2. Feasibility of the KREHA training progression (number of sessions adapted)

    Time frame: Throughout the intervention phase, week 0-12

    Feasibility of the KREHA training progression, by assessing how many training sessions needed to be adapted.

  3. Feasibility of the KREHA training progression (power adaptation)

    Time frame: Throughout the intervention phase, week 0-12

    Feasibility of the KREHA training progression, by assessing how much the target power (in Watts) of a training session needed to be adapted compared to the initially planned progression.

Study contacts

Contact information is provided by the study sponsor or research team.

Anneke Hertig-Godeschalk, PhD

CONTACT

[email protected]

+414 9396603

Fabian Ammann, MSc

CONTACT

[email protected]

+41419396624

Sponsors and collaborators

Lead sponsor

Swiss Paraplegic Research, Nottwil

Network

Registry information

Official study title

The Effects of Eccentric Compared to Standard Strength Training in Primary Spinal Cord Injury Rehabilitation - a Matched-Pair Randomized Controlled Trial

Acronym: KREHA3

Important dates

Study start
2026
Primary completion
2028
Study completion
2028
First posted
Apr 1, 2025
Registry last updated
Jul 8, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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