Development of a wheelchair exercise training program for persons with multiple sclerosis using a community-engaged research approach

项目摘要 这个博士后奖学金申请(F32)的目标是加速西尔维拉博士的 作为一名独立科学家进行发展，并促进现有的卫生知识和资源 使用轮椅的多发性硬化症(MS)患者通过运动训练进行推广。 目前约有100万美国人与多发性硬化症患者同住。 多发性硬化症绝大多数集中在活动人群中，尽管高达32%的多发性硬化症人口 有更严重的病程，需要全部或部分时间使用轮椅。这一段 多发性硬化症人群可能需要基于重大障碍的结构化运动训练计划 与参与生活方式体育活动相关，包括社区可达性、成本和天气。 目前还没有针对这部分MS人群的广泛可用的运动训练计划。 运动训练计划对促进健康和独立至关重要，而且有潜力 减少多发性硬化症患者的长期医疗费用(如治疗心血管疾病和糖尿病的药物)。 拟议的研究利用了西尔维拉博士进行的关于偏好的初步定性调查 为居住在美国各地使用轮椅的多发性硬化症患者提供运动培训计划。 西尔维拉博士是唯一适合领导这项拟议研究的人，因为他之前接受过适应健康促进的培训 培训环境中可提供的课程和指导，可促进成功完成培训 目标和具体目标。西尔维拉博士将与适应性运动领域的领先专家合作，创造一种新的 满足使用轮椅的多发性硬化症患者的需求的锻炼计划(目标1)。这些产品将 由初步数据、当前实用的临床试验材料提供信息，并使用社区- 采用研究方法，要求MS社区顾问提供批判性反馈(目标2)。 这项研究在超越西尔维拉博士成为一名 通过提供定向培训和课程经验的独立应用康复研究人员 开发、项目管理和临床试验。发起人(Robert Motl教授)是物理学教授 治疗和UAB/湖岸研究协作组的副主任，并将 提供必要的专业知识，以指导成功完成拟议的目标。赞助商 此外，还拥有在学术环境中培训成功的独立科学家的广泛记录。该公司- 赞助商(James Rimmer教授)是行动不便人士运动适应方面的专家， 在创建和实施锻炼计划方面建立了成功的记录。建议进行的研究 包括全面的培训计划，包括定期安排的会议、教育课程、直接 经验，以及关于临床试验方法学、行为改变理论和运动医学的研讨会。

Project Summary The objective of this postdoctoral fellowship application (F32) is to accelerate Dr. Silveira’s development as an independent scientist and advance the current knowledge and resources for health promotion through exercise training in persons with multiple sclerosis (MS) who use wheelchairs. Approximately 1 million Americans are currently living with MS. Physical activity research in persons with MS has overwhelmingly focused on persons who are ambulatory, though up to 32% of the MS population has a more progressed disease course that requires full or part-time use of a wheelchair. This segment of the MS population may require structured exercise training programs based on the presence of significant barriers associated with engaging in lifestyle physical activity, including community accessibility, cost, and weather. There are currently no widely available exercise training programs for this segment of the MS population. Exercise training programs are critical for promoting wellness and independence and have the potential for reducing long-term health-care costs (e.g., medications for CVD & diabetes) among persons living with MS. The proposed study leverages preliminary qualitative inquiry conducted by Dr. Silveira regarding preferences for an exercise training program among persons with MS living across the United States who use wheelchairs. Dr. Silveira is uniquely suited to lead the proposed research due to prior training in adapting health promotion curriculum and mentorship available in the training environment that promote successful completion of training goals and specific aims. Dr. Silveira will work with leading experts in adaptive exercise and create a novel exercise program that meets the needs of persons with MS who use wheelchairs (Aim 1). These products will be informed by preliminary data, current pragmatic clinical trial materials, and modified using community- engaged research approach by requesting critical feedback from community advisors with MS (Aim 2). This study serves several roles in exceling Dr. Silveira toward the ultimate goal of becoming an independent applied rehabilitation researcher by providing directed training and experience in curriculum development, project management, and clinical trials. The Sponsor (Prof. Robert Motl) is Professor of Physical Therapy and the Associate Director of Research at the UAB/Lakeshore Research Collaborative, and will provide the expertise necessary for guiding the successful completion of the proposed aims. The Sponsor further has an extensive record of training successful independent scientists in academic settings. The Co- Sponsor (Prof. James Rimmer) is an expert in exercise adaptations for persons with mobility impairments and has established a record of success in creating and implementing exercise programs. The proposed study includes a comprehensive training plan with regularly scheduled meetings, educational courses, direct experiences, and workshops on clinical trial methodology, behavior change theory, and exercise medicine.