Abstract
Objective
To compare the effectiveness of 2 home-based behavioral interventions for wheelchair
users to promote exercise adoption and maintenance over 12 months.
Design
Randomized controlled trial, with participants stratified into groups based on disability
type (stable, episodic, progressive) and support partner availability.
Setting
Exercise occurred in participant-preferred locations (eg, home, recreation center),
with physiological data collected at a university-based exercise laboratory.
Participants
Inactive wheelchair users (N=128; 64 women) with sufficient upper arm mobility for
arm-based exercise were enrolled. Participants on average were 45 years of age and
lived with their impairment for 22 years, with spinal cord injury (46.1%) most commonly
reported as causing mobility impairment.
Interventions
Both groups received home-based exercise interventions. The staff-supported group
(n=69) received intensive exercise support, while the self-guided group (n=59) received
minimal support. Both received exercise information, resistance bands, instructions
to self-monitor exercise, regularly scheduled phone calls, and handwritten cards.
Main Outcome Measures
The primary outcome derived from weekly self-reported exercise. Secondary outcomes
included physical fitness (aerobic/muscular) and predictors of exercise participation.
Results
The staff-supported group reported significantly greater exercise (∼17min/wk) than
the self-guided group over the year (t=10.6, P=.00), with no significant between-group difference in aerobic capacity (t=.76, P=.45) and strength (t=1.5, P=.14).
Conclusions
Although the staff-supported group reported only moderately more exercise, the difference
is potentially clinically significant because they also exercised more frequently.
The staff-supported approach holds promise for encouraging exercise among wheelchair
users, yet additional support may be necessary to achieve more exercise to meet national
recommendations.
Keywords
List of abbreviations:
ACSM (American College of Sports Medicine), AIC (Akaike information criterion), HR (heart rate), SCI (spinal cord injury), SRAHP (Self-Rated Abilities for Health Practices Scale), THR (target heart rate)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 18, 2013
Footnotes
Froehlich-Grobe was affiliated with the University of Kansas during the data collection phases, moving to the University of Texas in the final study year when data analyses occurred.
Supported by the National Institute of Child Health and Human Development/National Institutes of Health (grant no. R01 HD048628) and in part by a CTSA grant initially from NCRR and now from NCATS awarded to the University of Kansas Medical Center for Frontiers: The Heartland Institute for Clinical and Translational Research # UL1TR000001 (formerly # UL1RR033179). The contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Institutes of Health, National Institute of Child Health and Human Development, or National Center for Medical Rehabilitation Research.
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Clinical Trial Registration No.: NCT00866112.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
