Our study is a prospective observational study. Regardless of whether the exercises are
performed conventionally or using an alternative platform such as a wheelchair treadmill,
all interventions included in the study are routine clinical practices. Patients whose
treatment programs already adhere to the aforementioned procedures will be included in
the study. In the Upper Extremity and Hand Rehabilitation Laboratory, where the
wheelchair treadmill is available, patients with spinal cord injuries undergo a
standardized rehabilitation program as part of routine clinical practice. This laboratory
operates on a scheduled appointment basis.
After random allocation into groups, patients in the experimental group will be assessed
at the beginning and end of the wheelchair treadmill therapy. Meanwhile, patients in the
control group will be enrolled in the study before initiating wheelchair treadmill
therapy. Once the data from the control group have been collected, these patients will
also have the opportunity to receive wheelchair treadmill therapy.
The wheelchair treadmill to be utilized in the study is the h/p/cosmos saturn® 300/100 r
model. The device includes two separate safety belts for the participant and the
wheelchair, along with a wheelchair stabilizer equipped with three different locking
mechanisms. Additionally, three emergency stop buttons located in different areas ensure
maximum patient safety.
Treadmill exercises will be conducted at a submaximal level with a 0.7% incline. Heart
rate will be monitored using a portable device. Regardless of whether the exercises are
performed conventionally or on a treadmill, all exercises are part of routine clinical
practice. Patients already receiving treatment in accordance with the aforementioned
procedure will be included in the study. Participants will be randomly assigned to
groups.
Data Quality and Management Procedures Patients admitted for inpatient treatment at the
Spinal Cord Injury Rehabilitation Clinic of Ankara Bilkent City Hospital, who meet the
inclusion criteria and voluntarily agree to participate in the study by reading and
signing the informed consent form, will be included in the study. The medical status of
all participants will be evaluated and recorded by the clinical research responsible
physician. Exercise interventions will be carried out by two experienced physiotherapists
working at the hospital. The patients' data will also be collected by these two
physiotherapists.
Volunteers will be assessed at Ankara City Hospital Physical Therapy and Rehabilitation
Hospital, within the Spinal Cord Injury Rehabilitation Neurophysiological Exercise
Laboratory and the Upper Extremity and Hand Rehabilitation Laboratory, utilizing the
treadmill available in the facility's sports hall.
A predefined data management plan will be implemented for missing, inconsistent, or
erroneous data. Missing data will be identified and analyzed using statistical methods
such as multiple imputation when necessary.
To ensure the integrity of data entry, regular audits and consistency checks will be
performed by another physiotherapist involved in the study. To increase the reliability
of the data, patient records and assessment reports will be cross-checked with the
collected data. This will include comparisons made with electronic health records,
paper-based case reports, and direct observation notes. All study procedures, including
patient recruitment, data collection, data entry, data analysis, and reporting of adverse
events, will be carried out according to predefined criteria.
Any adverse events or unexpected complications occurring during the study will be
systematically documented and reported.
To determine the appropriate sample size, 10 patients per group will be included. Based
on the obtained pilot data, a power analysis will be conducted using the G* Power program
(version 3.0.10, Universität Düsseldorf, Düsseldorf, Germany).
For statistical analysis, descriptive statistics will be presented as the mean and
standard deviation for numerical variables if the parametric assumptions are met, and as
the median and minimum-maximum values if the parametric assumptions are not met. For
categorical variables, frequency and percentage values will be reported. The statistical
significance of differences between groups will be examined using the Independent Samples
T-Test if parametric assumptions are met, and the Mann-Whitney U Test if parametric
assumptions are not met. Analyses will be conducted with a significance level of p <
0.05.