Effect of Threshold Pressure-Loaded RMT + tTBS on Respiratory Function in SCI Patients

NCT ID: NCT07050069

Last Updated: 2025-07-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

60 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-12-25

Study Completion Date

2025-12-25

Brief Summary

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The purpose of this clinical trial is to understand whether threshold pressure load respiratory muscle training combined with iTBS can effectively improve the respiratory function of SCI patients. The main questions it aims to answer are:

* The impact of threshold pressure load respiratory muscle training on the respiratory function of SCI patients.
* The impact of iTBS treatment at the cortical projection point of the diaphragm on the respiratory function of SCI patients.
* Whether the combination of the above two treatment techniques is superior to single treatment.

Detailed Description

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Researchers will combine threshold pressure load respiratory muscle training and transcranial iTBS and compare them with single treatments to see if the combined treatment is superior to single treatment.

Participants will:

* Undergo threshold pressure load respiratory muscle training or transcranial iTBS treatment or a combination of both daily for 4 weeks.
* Visit the hospital for check-ups and tests every 2 weeks.
* Record their symptoms and respiratory function.

Conditions

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Spinal Cord Injuries

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Group A: sham stimulation + threshold pressure-loaded respiratory muscle training; Group B: iTBS + traditional respiratory training; Group C: iTBS + threshold pressure-loaded respiratory muscle training.
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Outcome Assessors

Study Groups

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Group A: sham stimulation + threshold pressure-loaded respiratory muscle training

Sham Stimulation "8" coil at bilateral diaphragmatic cortical projections (2-3 cm ant. to coronal line, 3 cm lat. to midline). 80% MT intensity. Each pulse train: 3 bursts (50 Hz intra/5 Hz inter), 2s on/8s off. Total 1,200 pulses (600/side), 5 sess/wk × 20 sess. Coil at 90° to scalp to avoid cortical current.

Threshold Pressure-Loaded RMT Saike trainer used. Pt. seated/reclined, nasal clips occluding nares. Filter mouthpiece connected to valve; tight oral seal. Resistance: 30% of MIP/MEP. 10 min inhale/exhale each, 20 min/d. Weekly MIP/MEP reassessment to adjust resistance. 4 wk, 5 d/wk.

Group Type EXPERIMENTAL

Transcranial Magnetic Stimulation (TMS) Device / Respiratory Training Device

Intervention Type DEVICE

Participants received group-specific interventions 5 days/week for 4 weeks.

Group B: iTBS + traditional respiratory training

iTBS Therapy 8-shape coil at bilateral diaphragmatic cortical projections (2-3 cm ant. to coronal line, 3 cm lat. to midline). 80% MT. Each pulse train: 3 bursts (50 Hz intra/5 Hz inter), 2s on/8s off. Total 1,200 pulses (600/side), 5 sess/wk × 20 sess.

Traditional Respiratory Training 5 therapist-led maneuvers: Pursed-lip: inhale (3-4s) via nose, pause (1-2s), exhale (5-6s) with pursed lips (6-8 br/min), 20 br/set.

Diaphragmatic: seated/supine, hands over umbilicus. Inhale to expand abdomen (3-5s), exhale to compress (6-8s). 4-6 br/min, 20 br/set.

Forced exhale: inhale (3-5s), forcefully exhale "ha" (2-3s), 4-6 br/min, 20 br/set.

Resisted inhale: supine, 1kg sandbag on umbilicus. Diaphragmatic breathing (4-6 br/min), 20 br/set.

3 sets/d, 5d/wk × 4wk.

Group Type EXPERIMENTAL

Transcranial Magnetic Stimulation (TMS) Device / Respiratory Training Device

Intervention Type DEVICE

Participants received group-specific interventions 5 days/week for 4 weeks.

Group C: iTBS + threshold pressure-loaded respiratory muscle training

iTBS Therapy 8-shape coil at bilateral diaphragmatic cortical projections (2-3 cm ant. to coronal line, 3 cm lat. to midline). 80% MT. Each pulse train: 3 bursts (50 Hz intra/5 Hz inter), 2s on/8s off. Total 1,200 pulses (600/side), 5 sess/wk × 20 sess.

Threshold Pressure-Loaded RMT Saike trainer used. Pt. seated/reclined, nasal clips occluding nares. Filter mouthpiece connected to valve; tight oral seal. Resistance: 30% of MIP/MEP. 10 min inhale/exhale each, 20 min/d. Weekly MIP/MEP reassessment to adjust resistance. 4 wk, 5 d/wk.

Group Type EXPERIMENTAL

Transcranial Magnetic Stimulation (TMS) Device / Respiratory Training Device

Intervention Type DEVICE

Participants received group-specific interventions 5 days/week for 4 weeks.

Interventions

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Transcranial Magnetic Stimulation (TMS) Device / Respiratory Training Device

Participants received group-specific interventions 5 days/week for 4 weeks.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Patients with spinal cord injury (SCI) meeting the 2019 revised International Standards for Neurological Classification of Spinal Cord Injury by the American Spinal Injury Association (ASIA), confirmed by CT/MRI.
* Aged 18-80 years.
* Time since injury: 2 weeks to 6 months, with spinal shock resolved.
* Injury level at T12 or above, ASIA Impairment Scale (AIS) grade A-C.
* Patients providing written informed consent after study explanation.

Exclusion Criteria

* Patients with severe cardiorespiratory diseases (e.g., pneumothorax).
* Unstable vital signs (e.g., hypotension, arrhythmia).
* Cognitive/psychiatric disorders precluding cooperation.
* Requiring mechanical ventilation.
* Congenital spinal/limb deformities.
* Contraindications to magnetic stimulation: intracranial metal implants, pacemakers, etc.
Minimum Eligible Age

18 Years

Maximum Eligible Age

80 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Shengjing Hospital

OTHER

Sponsor Role lead

Responsible Party

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Xue Jiang

Associate Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Jiang Xue

Role: PRINCIPAL_INVESTIGATOR

Rehabilitation Center of Shengjing Hospital, China Medical University

Locations

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Rehabilitation Center of Shengjing Hospital, China Medical University

Shenyang, Liaoning, China

Site Status RECRUITING

Countries

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China

Central Contacts

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Jiang Xue

Role: CONTACT

+86 18940254064

Zhang Di

Role: CONTACT

+86 15291000208

Facility Contacts

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Xue Jiang

Role: primary

+86 189 4025 4064

Di Zhang

Role: backup

+86 15291000208

Other Identifiers

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2024PS1936K

Identifier Type: -

Identifier Source: org_study_id

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