Exercise for Everyone: A randomized controlled trial of Project Workout On Wheels in promoting exercise among wheelchair users

Abstract

Objective

To compare the effectiveness of two home-based behavioral interventions to promote wheelchair users 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 (e.g., home, recreation center), with physiological data collected at the university-based exercise lab.

Participants

One hundred twenty-eight inactive wheelchair users (64 women) with sufficient upper arm mobility for arm-based exercise enrolled. Participants on average were 45 years old, 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 (~ 16 minutes/week) than the self-guided group over the year (t=10.6, p=0.00), with no significant between group difference in aerobic capacity (t=0.76, p=0.45) and strength (t=1.5, p=0.14).

Conclusions

Although the staff-supported group reported only moderately more exercise, the difference is potentially clinically significant as 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.