Malone Laurie A, Mehta Tapan, Mendonca Christen J, Mohanraj Sangeetha, Thirumalai Mohanraj
Department of Occupational Therapy, School of Health Professions, The University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Family and Community Medicine, The University of Alabama at Birmingham, Birmingham, AL, USA.
Pilot Feasibility Stud. 2024 Aug 2;10(1):104. doi: 10.1186/s40814-024-01528-x.
People with mobility limitations have a disproportionately higher rate of acquiring secondary conditions such as obesity, cardiovascular comorbidity, pain, fatigue, depression, deconditioning, and type 2 diabetes. These conditions often result from poor access to home and community-based health promotion/wellness programs. The aim of this project was to determine the feasibility of delivering an online community membership-based fitness program for individuals with mobility impairments.
For this prospective single-arm study, participants were recruited from members of a community fitness facility that serves people with physical disabilities and chronic health conditions. While all members had access to the online platform, individuals had to opt-in to participate in the research component. Activity options included 16 pre-recorded videos and 9 live exercise classes. During the 8-week program, participants had an opportunity to earn three exercise incentives for reaching certain activity milestones. Enrollment percentage, attendance, and attrition were tracked to assess program feasibility and acceptability. Changes in participant-reported outcomes including self-reported physical activity, psychosocial outcomes, and health-related quality of life (HRQOL) were examined using non-parametric analyses.
A total of 146 eligible individuals were screened of which 33 enrolled (22.6%). Two participants withdrew from the study, so a total of 31 were used for analyses. Participants included 29 women and 12 Black people with an average age of 60 (± 15.9) years. Health conditions included stroke, post-polio, arthritis, neuropathy, cerebral palsy, and obesity. Ten participants used an assistive device to get around inside the home. Twenty-six participants (78.8%) completed the online program, and 5 participants earned all 3 participation incentives. The mean number of live Zoom exercise classes attended by the participants was 12.8 (range = 0-43) over 8 weeks; 3 of 31 participants did not attend any classes. On average, participants watched 128 min (range = 0-704 min) of pre-recorded videos; 6 of 31 participants did not view any pre-recorded videos. Self-reported physical activity showed the largest improvement (11.15 units; 95% CI, 3.08, 19.56) with an effect size of 0.51 (Cohen's d).
This pilot study of an online membership-based fitness program for people with mobility impairments demonstrated preliminary effectiveness in increasing physical activity and was found to be feasible and acceptable. Feasibility endpoints do indicate potential to improve retention. These results suggest that online delivery of exercise programs can broaden the reach of specialized community fitness programs and is a promising direction for future work and fully powered trials are warranted to assess intervention efficacy.
ClinicalTrials.gov, NCT05138809. Registered September 2, 2021, ClinicalTrials.gov PRS: Record Summary NCT05138809.
行动不便的人群患继发性疾病的比例高得不成比例，这些疾病包括肥胖、心血管合并症、疼痛、疲劳、抑郁、身体机能衰退和2型糖尿病。这些疾病往往是由于难以获得家庭和社区健康促进/健康计划所致。本项目的目的是确定为行动不便者提供基于在线社区会员制的健身计划的可行性。
在这项前瞻性单臂研究中，参与者从一个为身体残疾和慢性健康状况患者服务的社区健身设施的会员中招募。虽然所有会员都可以访问在线平台，但个人必须选择加入才能参与研究部分。活动选项包括16个预录制视频和9节现场健身课程。在为期8周的计划中，参与者有机会因达到某些活动里程碑而获得三项运动奖励。跟踪注册百分比、出勤率和流失率，以评估计划的可行性和可接受性。使用非参数分析检查参与者报告的结果变化，包括自我报告的身体活动、心理社会结果和健康相关生活质量（HRQOL）。
共筛选出146名符合条件的个体，其中33人注册（22.6%）。两名参与者退出了研究，因此共有31人用于分析。参与者包括29名女性和12名黑人，平均年龄为60（±15.9）岁。健康状况包括中风、小儿麻痹后遗症、关节炎、神经病变、脑瘫和肥胖。10名参与者在家中使用辅助设备出行。26名参与者（78.8%）完成了在线计划，5名参与者获得了全部三项参与奖励。参与者在8周内参加的现场Zoom健身课程平均数量为12.8节（范围为0 - 43节）；31名参与者中有3人未参加任何课程。平均而言，参与者观看了128分钟（范围为0 - 704分钟）的预录制视频；31名参与者中有6人未观看任何预录制视频。自我报告的身体活动改善最大（11.15个单位；95%可信区间，3.08，19.56），效应大小为0.51（科恩d值）。
这项针对行动不便者的基于在线会员制的健身计划的试点研究在增加身体活动方面显示出初步效果，并且被发现是可行和可接受的。可行性终点确实表明有提高留存率的潜力。这些结果表明，在线提供锻炼计划可以扩大专门社区健身计划的覆盖范围，是未来工作的一个有前景的方向，有必要进行全面有力的试验来评估干预效果。
ClinicalTrials.gov，NCT05138809。于2021年9月2日注册，ClinicalTrials.gov PRS：记录摘要NCT05138809。
