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一项由同伴协助的针对脊髓损伤或疾病老年患者的远程手摇车运动项目的可行性及效果:一项混合方法病例系列研究

The feasibility and effect of a peer-facilitated, remote handcycling sport program for aging adults with spinal cord injury or disease: a mixed methods case series.

作者信息

Cheung Lovisa, Buren Robert, Benn Natasha L, Alton Charlene, Craven B Catharine, Marzolini Susan, Musselman Kristin E

机构信息

Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.

KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.

出版信息

Spinal Cord Ser Cases. 2025 Sep 10;11(1):26. doi: 10.1038/s41394-025-00721-1.

Abstract

STUDY DESIGN

Concurrent mixed methods case series.

OBJECTIVES

To examine the feasibility and effect of a peer-facilitated, remote handcycling sport program on physical, psychological, and social health of individuals with spinal cord injury or disease (SCI/D) aged ≥50 years.

SETTING

Participants' homes.

METHODS

Manual wheelchair users aged ≥50 years with chronic SCI/D were eligible. Participants completed remote, group-based handcycling at moderate-vigorous intensity twice weekly for 12 weeks, co-led by a physiotherapist and peer with SCI/D. Handcycling duration was progressively increased to 45 min. Outcome measures were completed at three timepoints (pre-, post-, 12 weeks post-training). True change was assessed using the two-standard deviation band method for the Spinal Cord Independence Measure, Moorong Self-Efficacy Scale, Exercise Self-Efficacy Scale (ESES), Positive Affect and Well-Being Scale, and Multidimensional Scale of Perceived Social Support, and minimal detectable change for the 6 min Push Test (6MPT). Semi-structured interviews were analyzed using thematic analysis.

RESULTS

Five participants enrolled; four completed the program and one was withdrawn following fractures unrelated to program. Overall, divergence was observed when comparing quantitative and qualitative findings. Interview data revealed participants perceived physical, psychological, and social health improvements, but there was minimal change in quantitative scores. A few instances of convergence were noted; e.g., immediately post-intervention, SP01 experienced improvement in 6MPT distance, which corroborated SP01's perceived physical health improvements. At 12-week follow-up, SP03 experienced reduction in ESES score, which aligned with SP03's reports of skin issues limiting sport.

CONCLUSIONS

Remote handcycling provided some health benefits for participants with SCI/D aged ≥50 years.

摘要

研究设计

同期混合方法病例系列研究。

目的

探讨由同伴协助的远程手摇车运动项目对年龄≥50岁的脊髓损伤或疾病(SCI/D)患者身体、心理和社会健康的可行性及效果。

地点

参与者家中。

方法

年龄≥50岁、患有慢性SCI/D的手动轮椅使用者符合条件。参与者在物理治疗师和患有SCI/D的同伴共同指导下,每周两次进行强度为中等到剧烈的远程团体手摇车运动,为期12周。手摇车运动时长逐渐增加至45分钟。在三个时间点(训练前、训练后、训练后12周)完成结果测量。使用脊髓独立测量量表、Moorong自我效能量表、运动自我效能量表(ESES)、积极情感与幸福感量表以及感知社会支持多维量表的双标准差带法评估真实变化,使用6分钟推轮椅测试(6MPT)的最小可检测变化进行评估。采用主题分析法对半结构化访谈进行分析。

结果

5名参与者入组;4名完成了该项目,1名因与项目无关的骨折退出。总体而言,在比较定量和定性结果时观察到了差异。访谈数据显示参与者认为身体、心理和社会健康有所改善,但定量评分变化极小。注意到一些趋同的情况;例如,干预后即刻,SP01的6MPT距离有所改善,这证实了SP01感知到的身体健康改善。在12周随访时,SP03的ESES评分降低,这与SP03报告的皮肤问题限制运动情况相符。

结论

远程手摇车运动为年龄≥50岁的SCI/D参与者带来了一些健康益处。

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