Improving Cardiorespiratory Fitness and Cardiometabolic Health among Children with Physical Disabilities through Movement-to-Music Telehealth with Arm-based Sprint-Intensity Interval Training

拜伦赖，博士- R21

Byron Lai, PhD – R21 Project Summary/Abstract Due to alarmingly low rates of exercise participation, children with physical disabilities are at substantially high risk for cardiovascular disease (CVD), related conditions, and CVD mortality as they age into adulthood. Regular participation in aerobic exercise is an effective non-pharmaceutical method for preventing cardiovascular disease and metabolic syndrome, but effective modalities such as walking, running, and cycling are often not suitable for children with disabilities, who have impaired mobility. The growing availability of internet access and acceptance of telehealth (due to the coronavirus pandemic) create an unprecedented opportunity to engage large, underserved groups of children with disabilities in exercise behavior. However, ensuring that they maintain regular participation over periods of time that are necessary to elicit changes in cardiometabolic health will require enjoyable, accessible, and age-appropriate programs. This application proposes a pilot project that builds upon our recent feasibility work. The project will pilot an evidence-based, scale-up movement-to-music (M2M) program that has been newly revised for children with cerebral palsy who have functional impairments. The program includes three novel components: 1) pre-recorded videos that are stylized with visual graphics and enjoyable music to themes (e.g., superheroes, sports, pop music) that were requested by our feasibility participants; 2) arm-based routines with sprint-intensity interval training (SIT), based on principles from the latest exercise physiology research in the general population; and 3) replicable cloud-based tele-monitoring procedures. Participants will be recruited from a children’s hospital and network of community organizations. A total of 50 children with cerebral palsy will be randomized to one of two groups: 12 weeks of SIT-M2M or 12-week waitlist control that undergoes habitual activity before receiving SIT-M2M. The SIT prescription will include 3 sessions per week of 30 repeated sequences of 4-s of maximal arm exercise, with active recovery periods (~20-min sessions with a warm-up and cool down period). This study will compare changes between groups in outcomes related to cardiovascular fitness and core indicators of cardiometabolic health, namely, body composition, body weight, high sensitivity C-reactive protein, hemoglobin A1c, triglycerides, cholesterol, and blood pressure. Additionally, the study will record implementation metrics that will inform the design of a follow-up trial. Study findings will inform the development of a convenient telehealth efficacy trial for implementation across various sites and settings to improve the health and well- being of children with disabilities who cannot walk or stand for prolonged periods of time.