Article

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 ( approximately 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.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS