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

Rimmer, James H.; Mehta, Tapan; Wilroy, Jereme; Lai, Byron; Young, Hui-Ju; Kim, Yumi; Pekmezi, Dori; Thirumalai, Mohanraj

doi:10.1136/bmjopen-2018-023538

Cited by 15 publications

(5 citation statements)

References 66 publications

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“…Motivational strategies will include positive verbal encouragement to bolster exercise confidence (ie, self-efficacy) and performing the exercises with the participant to enhance learning through observation (ie, vicarious learning). These strategies are informed by social cognitive theory [ 88 ], and the research team has used these strategies in other trials [ 55 , 83 , 86 , 89 ]. To monitor exercise intensity, the telecoach will ask participants how hard they are working after every change in song (~5 minutes) throughout the session.…”

Section: Methodsmentioning

confidence: 99%

Telehealth Movement-to-Music With Arm-Based Sprint-Intensity Interval Training to Improve Cardiometabolic Health and Cardiorespiratory Fitness in Children With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial

Lai,

Oster,

Davis

et al. 2024

JMIR Res Protoc

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Background Children with mobility disabilities, including those with cerebral palsy, have limited options and limited time to exercise to manage their cardiometabolic health and cardiorespiratory fitness. Regular cardiovascular exercise during childhood is a critical health behavior for preventing health decline in adulthood. Thus, there is an urgent need for accessible, age-appropriate, convenient exercise modalities in this group. Sprint-intensity interval training (SIT), combined with telehealth procedures, may be ideal for children with disabilities. SIT includes repetitive bouts of maximal exercise effort combined with rest periods, which can be effective in eliciting comparable results to moderate-exercise training with very short training durations. Objective This phase 1 pilot feasibility randomized controlled trial aims to investigate the potential effects of a 12-week SIT program on indicators of cardiorespiratory fitness and cardiometabolic health among children with cerebral palsy. An ancillary aim is to evaluate the feasibility of the program through several process feasibility metrics. Methods This study uses a 2-armed parallel group design. A total of 50 physically inactive children with cerebral palsy (aged 6-17 years) will be randomly allocated into 1 of 2 groups: a 12-week SIT or a waitlist control group that continues habitual activity for 12 weeks. The SIT prescription includes 3 tele-supervised sessions per week with 30 repeated sequences of 4 seconds of maximal arm exercise, with active recovery, warm-up, and cooldown periods (for an approximately 20-minute total session). SIT includes guided videos with child-themed arm routines and music. The exercise sessions will be remotely supervised through a web-based videoconference application and include safety monitoring equipment. Outcomes are measured at pre- and postintervention (weeks 0 and 13, respectively). Health outcome measures include peak oxygen consumption (VO2 peak), measured by a graded exercise test; high-sensitivity C-reactive protein and blood insulin, hemoglobin A1c, triglycerides, and cholesterol using a finger stick dried blood spot test; blood pressure, using a sphygmomanometer; and body composition (total mass, total lean mass, tissue % lean, and tissue % fat) using dual x-ray absorptiometry. Feasibility will be evaluated by the following metrics: adverse events or problems experienced throughout the intervention related to participant safety; perceived enjoyment; and recruitment, enrollment, and attrition rates. Results Recruitment procedures started in November 2023. All data are anticipated to be collected by February 2025. Full trial results are anticipated to be analyzed and submitted for publication by March 2025. Secondary analyses of data will be subsequently published. Conclusions This trial tests an accessible and low-cost exercise program that leverages principles of high-intensity exercise to provide a convenient program for children with physical disabilities. Knowledge obtained from this study will inform the development of a larger trial for improving the cardiometabolic health, cardiorespiratory fitness, and well-being of children with physical disabilities. Trial Registration ClinicalTrials.gov NCT05619211; https://clinicaltrials.gov/study/NCT05619211 International Registered Report Identifier (IRRID) DERR1-10.2196/56499

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Section: Methodsmentioning

confidence: 99%

Telehealth Movement-to-Music With Arm-Based Sprint-Intensity Interval Training to Improve Cardiometabolic Health and Cardiorespiratory Fitness in Children With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial

Lai,

Oster,

Davis

et al. 2024

JMIR Res Protoc

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“…Mindfulness classes are taught once per week for 1 hour by a trained mindfulness instructor and are based on the core elements of mindfulness, including positioning (adapted for wheelchair users), focusing on the breath, and reducing unwanted thought patterns. Exercise classes are offered 2 days per week for 1 hour each class by trained instructors and include movement-to-music ( 28 ), complementary alternative medicine (yoga, Pilates, dual-tasking exercises) ( 29 ), and general fitness classes. Each class includes adaptations tailored to a participant’s functional level.…”

Section: Methodsmentioning

confidence: 99%

“…Participants signed up for an 8-week, 40-hour program (5 h/wk) that delivers online classes on evidence-based wellness practices (ie, health promotion) designed to support participants in improving their health (27). The core wellness domains are mindfulness, exercise, and nutrition.…”

Section: Description Of Mentormentioning

confidence: 99%

Enhancements to a Telewellness Program for People With Physical Disabilities: Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR 2.0)

Rimmer,

Young,

Bachiashvili

et al. 2024

Prev. Chronic Dis.

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Introduction This study evaluated the National Center on Health, Physical Activity and Disability (NCHPAD) Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR) program for people with physical disabilities. Methods This retrospective evaluation of MENTOR 2.0, an 8-week online group health promotion program, was based on improvements from its first implementation (MENTOR 1.0). Baseline and postassessments included the Godin Leisure-Time Exercise Questionnaire (GLTEQ), NCHPAD Wellness Assessment (NWA), Connor-Davidson Resilience Scale, and Mindfulness Attention Awareness Scale. Estimates and corresponding 95% CIs from linear mixed models were provided to compare baseline and postassessment scores and effect sizes using Cohen d. Results Among 116 participants (mean age, 53 y; 63% female), postassessment scores increased significantly in the overall NWA and in all 15 NWA domains (effect size, 0.30–0.69). The overall NWA score was 7.59 (95% CI, 5.63–9.56) units higher at postassessment compared with baseline. Scores for GLTEQ health contribution increased significantly among participants with low baseline scores (31.37 [95% CI, 12.97–49.77]) (effect size, 0.50). Mindfulness and resilience scores both showed improvement (0.16 [95% CI, 0.01–0.31]; effect size, 0.15) and (0.72 [95% CI, −0.25 to 1.68]; effect size 0.09), respectively, but only the change in mindfulness was significant. Conclusion MENTOR 2.0 advanced the evaluation of this online telewellness program for people with physical disabilities by demonstrating consistent results with MENTOR 1.0. We reported improvements in GLTEQ, especially among those with lower baseline scores; in multiple areas of wellness, including physical, mental, and emotional/spiritual health; and in mindfulness and resilience, although the improvements in these 2 constructs were small.

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“…A few of these barriers include accessibility of facilities, opportunity for activity, and aesthetic or environmental attributes [6]. In order to overcome these barriers, people with physical disabilities must be given more options for home-based activity, thus eliminating many well-known community-based barriers [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…The SUPER-HEALTH project, which stands for Scale-Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health, is an ongoing 48-week exercise trial assessing the utilization of a movement-to-music (M2M) intervention remotely delivered to various disability groups [8]. SUPER-HEALTH recruits individuals with a mobility impairment, defined as the inability to walk or difficulty walking as a means to exercise, and includes people with spinal cord injury (SCI), spina bifida (SB), multiple sclerosis (MS), stroke, limb loss, and other disabilities and chronic health conditions.…”

Section: Introductionmentioning

confidence: 99%

Teleassessments for Enrollment of Adults With Physical or Mobility Disability in a Home-Based Exercise Trial in Response to COVID-19: Usability Study (Preprint)

Wilroy¹,

Lai²,

Currie³

et al. 2021

Preprint

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BACKGROUND The Scale-Up Project Evaluating Responsiveness to Home Exercise And Lifestyle Tele-Health (SUPER-HEALTH) is a large randomized controlled study that aims to overcome logistical barriers to exercise via telehealth for people with physical disabilities. However, at the start of the COVID-19 pandemic, enrollment was halted due to a limited business model at the testing site, which included no on-site visits that involved participant data collection. In response to the limited operations, a modified data collection protocol was developed for virtual enrollment of study participants. OBJECTIVE This paper presents feasibility data for using teleassessments for enrolling people with mobility impairment into a home-based exercise trial. METHODS The modified protocol replaced onsite enrollment and data collection visits with teleassessments using a computer tablet and testing equipment that was shipped to the participants’ home address prior to the synchronous teleassessments conducted by an exercise physiologist and trained research assistant through Zoom. Participants were mailed a teleassessment toolkit that included a digital blood pressure cuff, spirometer, hand dynamometer, mini disc cone, and measuring tape (to complete standardized testing). The teleassessment measures included resting blood pressure and heart rate, forced vital capacity (FVC), grip strength, Five Times Sit to Stand, and Timed Up and Go. Feasibility metrics included enrollment, effectiveness, efficiency, and safety. Effectiveness of telehealth assessment was determined by the percentage of sessions completed without technical issues with ≥ 90% criteria set a priori. Efficiency was measured by the the duration of sessions with ≤ 2 hour criteria set a prior. Safety was measured by number of adverse events related to teleassessments reported. RESULTS Data from 36 participants were included in this feasibility study and 34 participants completed all teleassessments without technical issues (94.4%). For efficiency, the teleassessments sessions were completed in a mean time of 65 minutes and ranged from 41 – 110 minutes. There were no adverse events reported to indicate concerns with safety of teleassessments. CONCLUSIONS The modified teleassessment protocol, in response to COVID-19 restrictions, has shown to be a feasible process for enrolling adults with mobility impairment into a home exercise trial who otherwise would have not been able to participate. CLINICALTRIAL #NCT03024320

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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

Cited by 15 publications

References 66 publications

Telehealth Movement-to-Music With Arm-Based Sprint-Intensity Interval Training to Improve Cardiometabolic Health and Cardiorespiratory Fitness in Children With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial

Telehealth Movement-to-Music With Arm-Based Sprint-Intensity Interval Training to Improve Cardiometabolic Health and Cardiorespiratory Fitness in Children With Cerebral Palsy: Protocol for a Pilot Randomized Controlled Trial

Enhancements to a Telewellness Program for People With Physical Disabilities: Mindfulness, Exercise, and Nutrition To Optimize Resilience (MENTOR 2.0)

Teleassessments for Enrollment of Adults With Physical or Mobility Disability in a Home-Based Exercise Trial in Response to COVID-19: Usability Study (Preprint)

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