Characteristics of Adults With Neurologic Disability Recruited for Exercise Trials: A Secondary Analysis

Abstract

This review examined demographic and clinical characteristics of participants from exercise trials in 3 neurologic disability conditions (multiple sclerosis, spinal cord injury, and traumatic brain injury) and compared these data with population-based statistics. The authors included 75 published studies from 2006 to 2016: 53 studies for multiple sclerosis (n = 2,034), 14 for spinal cord injury (n = 302), and 8 for traumatic brain injury (n = 272). Pooled data resembled some heterogeneous aspects of population data sets. However, many characteristics were not reported; samples were small and predominantly White, and 48.1% of the people screened were excluded. Thus, findings from these studies may not be translatable across the range of people with these three conditions, which warrant efforts to target the inclusion of underrepresented subgroups in future exercise trials.

Critical factors influencing the decision to enroll in a physical activity intervention among a predominant group of adults with spinal cord injury: a grounded theory study

“…These concerns led to the development of a theory that may enhance recruitment strategies for PA programs. Recruitment is the current rate-limiting factor for implementing high-quality randomized controlled trials in this population [5,10] and severely attentuates external validity.…”

“…High-quality confirmatory evidence (i.e., randomized controlled trials and meta-analyses) can expedite the translation of carefully controlled clinical interventions into real-world community-settings, but PA studies have been consistently impeded by an inability to enroll large enough samples of people with SCI or wheelchair users to reach an adequate level of external validity [5,6]. A recent scoping review found that only 42% of adults with physical disabilities who were contacted agreed to enroll in a PA trial [10]. Common reasons for nonparticipation included unspecified refusal to participate, exclusion due to wheelchair use, difficulties with travel, unavailable transportation, and scheduling concerns [10].…”

“…A recent scoping review found that only 42% of adults with physical disabilities who were contacted agreed to enroll in a PA trial [10]. Common reasons for nonparticipation included unspecified refusal to participate, exclusion due to wheelchair use, difficulties with travel, unavailable transportation, and scheduling concerns [10]. However, further detail is required to create targeted strategies that increase enrollment among people with SCI and others who use wheelchairs.…”

“…National datasets demonstrate that people who use wheelchairs as a primary means of mobility are largely not participating in levels of physical activity (PA) that can provide health-related benefits [ 1 – 4 ]. Despite substantial growth in published clinical studies demonstrating benefits to physical fitness, function, and well-being among people with disabilities [ 5 – 9 ], research studies still struggle with recruiting people with SCI into PA trials [ 10 ].…”

Rationale and design of a Scale-Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health (SUPER-HEALTH) in people with physical/mobility disabilities: a type 1 hybrid design effectiveness trial

“…Despite what is known about the positive effects of exercise in improving health and function,1 people with physical disabilities remain one of the least active and obese2–8 populations in society. In the latest data from the Centers for Disease Control and Prevention, nearly one-half of all adults with disabilities perform no aerobic physical activity 9.…”