Wheelchair user physical activity training intervention to enhance cardiometabolic health (WATCH): A community-based randomized control trial

轮椅使用者身体活动训练干预以增强心脏代谢健康（WATCH）：一项基于社区的随机对照试验

• 批准号: 10598219
• 负责人: Kerri Ann Morgan
• 金额: $ 53.76万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10598219
• 关键词: Address; Adult; Aerobic Exercise; Age; Blood Vessels; Body Composition; Cardiovascular Diseases; Characteristics; Clinical Trials; Collaborations; Communities; Data; Diagnosis; Disease; Education; Educational Intervention; Environment; Equipment; Exercise; Face; Failure; Frequencies; Funding; Future; Gender; General Population; Goals; Guidelines; Health; Health Benefit; Hybrids; Intervention; Knowledge; Laboratories; Measures; Mediator; Metabolic; Modeling; Monitor; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Pain; Participant; Persons; Physical Function; Physical activity; Population; Positioning Attribute; Protocols documentation; Public Health; Race; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Sample Size; Sampling; Self Efficacy; Stroke; Structure; System; Training Activity; Training Support; United States; Wheelchairs; Work; actigraphy; cardiometabolic risk; cardiometabolism; cardiorespiratory fitness; cardiovascular risk factor; compare effectiveness; disability; evidence base; exercise intervention; experience; health knowledge; high risk; implementation intervention; implementation outcomes; implementation science; improved; intervention effect; moderate-to-vigorous physical activity; obesity risk; participant interview; prevent; primary outcome; programs; sedentary; strength training; success; therapy design; trial comparing

Project Summary: Low levels of physical activity (PA) are common in individuals who use wheelchairs due to physical disability. Wheelchair users (WU) are also at greater risk for obesity and cardiometabolic health-related diseases compared to the general population. Regular PA is widely recognized as being beneficial to the health of persons without a disability and is believed to hold similar benefits for WU. However, WU face barriers to PA, including considerable lack of accessible, community-based facilities, limited access to adapted equipment, lack of knowledge on how to exercise safely, and proper support. Additionally, it is unclear what type of PA intervention is most effective to facilitate WU in achieving current PA recommendations and reversing or preventing cardiometabolic health-related diseases. Thus, evaluating a structured, community-based PA training intervention with education and support is critical and will have significant implications for WU health, future PA guidelines for WU, and the activities of community-based organizations serving WU. The extensive health benefits of aerobic and strength training are well established for the general population, and randomized controlled trials studying the impact of PA for WU suggest programs that provide support and education in accessible, community-based environments are effective for improving outcomes such as strength and pain. However, there is insufficient evidence on whether these interventions result in cardiometabolic health (i.e., VO2peak) improvements in WU. Previous evidence demonstrates these interventions may be inadequate to reach the recommended frequency, intensity, and duration of PA. Preliminary data suggest guiding PA intensity may be essential to improving cardiometabolic health outcomes in WU. The current study proposes a hybrid I randomized controlled trial to test the cardiometabolic effects of a tailored intensity-controlled physical activity training (I PAT) intervention compared to education and access to a community-based accessible gym (EA). The following specific aims will be tested in WU randomized to either the IPAT or the EA intervention groups (N = 54 for both). Specific Aim #1: To compare the effectiveness of the IPAT to EA on cardiorespiratory fitness, vascular function, and body composition. Specific Aim #2: To identify barriers and facilitators to WU engaging in PA at a community-based, accessible gym. Specific Aim #3: To examine the mediators (e.g., self-efficacy) and moderators (e.g., age, race, duration of disability) of the expected intervention effect to understand differences in physiologic response. Moderate-to-vigorous intensity aerobic and strength training will be used to study the effects of interventions delivered in a community-based accessible gym on cardiometabolic related health outcomes such as cardiorespiratory fitness (VO2peak) and vascular function (endothelial function) in WU. Successful completion of the proposed study will generate data to inform future PA guidelines and strengthen the evidence base for safe and effective PA interventions.

项目摘要：低水平的体育锻炼（PA）在使用轮椅的个人中很常见 身体残疾。轮椅使用者（WU）也面临肥胖和心脏代谢健康有关的风险 与普通人群相比，疾病。普通PA被广泛认为是有益的 没有残疾的人的健康，被认为对吴有类似的利益。但是，吴的脸 PA的障碍，包括大量缺乏可访问的社区设施，有限的适应性访问权限 设备，缺乏有关如何安全锻炼的知识以及适当的支持。另外，目前尚不清楚 PA干预类型最有效地促进WU实现当前的PA建议和 逆转或防止心脏代谢健康相关疾病。因此，评估一个结构化的，基于社区的 对教育和支持的PA培训干预至关重要，将对 Wu Health，WU的未来PA指南以及为WU服务的社区组织的活动。这 有氧运动和力量训练的广泛健康益处已为普通人群确定，并 研究PA对WU的影响的随机对照试验建议提供支持和 在可访问，基于社区的环境中的教育对于改善结果有效 力量和痛苦。但是，没有足够的证据表明这些干预措施是否导致 WU中的心脏代谢健康（即VO2PEAK）改进。以前的证据证明了这些 干预措施可能不足以达到PA的建议频率，强度和持续时间。 初步数据表明，指导PA强度可能对于改善心脏代谢健康结果至关重要 在吴。当前的研究提出了一项混合I随机对照试验，以测试 与教育和访问相比，量身定制的强度控制体育活动培训（I PAT）干预 到基于社区的无障碍体育馆（EA）。以下特定目标将在WU中进行测试 IPAT或EA干预组（两者n = 54）。特定目的＃1：比较有效性 IPAT的eA涉及心肺适应性，血管功能和身体组成。特定目标＃2： 识别障碍物和促进者WU在社区，可访问的体育馆中参与PA。特定目标＃3： 检查调解人（例如自我效能感）和主持人（例如年龄，种族，残疾持续时间） 预期干预效果以了解生理反应的差异。中度到vig的强度 有氧和力量训练将用于研究基于社区的干预措施的影响 在心脏代谢相关的健康结果（例如心肺健身）（VO2PEAK）和 WU中的血管功能（内皮功能）。成功完成拟议的研究将生成数据 为未来的PA指南提供信息，并加强安全有效的PA干预的证据基础。