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

通过运动音乐远程医疗和基于手臂的冲刺强度间歇训练，改善身体残疾儿童的心肺健康和心脏代谢健康

• 批准号: 10645848
• 负责人: Byron Lai
• 金额: $ 22.28万
• 依托单位: UNIVERSITY OF ALABAMA AT BIRMINGHAM
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-05-01 至 2025-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10645848
• 关键词: Address; Adherence; Adolescent; Adult; Adverse event; Aerobic; Aerobic Exercise; Age; Behavior; Behavioral; Blood; Blood Pressure; Body Composition; Body Weight; Body measure procedure; C-reactive protein; Cardiovascular Diseases; Cerebral Palsy; Child; Child Welfare; Cholesterol; Community Networks; Control Groups; Development; Disabled Children; Doctor of Philosophy; Dryness; Dual-Energy X-Ray Absorptiometry; Enrollment; Ensure; Equipment; Exercise; Exercise Physiology; Exercise Test; Fatty acid glycerol esters; Fingers; General Population; Glycosylated hemoglobin A; Health; Health Benefit; Health Professional; Home; Impairment; Insulin; Internet; Interval training; Intervention; Knowledge; Leg; Literature; Longevity; Measures; Metabolic; Metabolic syndrome; Methods; Modality; Modeling; Modification; Monitor; Movement; Music; Outcome; Oxygen Consumption; Participant; Pediatric Hospitals; Persons; Physical Education; Physical activity; Pilot Projects; Procedures; Process; Program Appropriateness; Random Allocation; Randomized; Randomized, Controlled Trials; Recovery; Research; Research Personnel; Rest; Roentgen Rays; Running; Safety; Sample Size; Schools; Site; Sphygmomanometers; Spirometry; Sports; Spottings; Supervision; Techniques; Testing; Thinness; Time; Tissues; Training Programs; Translating; Transportation; Triglycerides; Underserved Population; Video Recording; Visual; Waiting Lists; Walking; Wheelchairs; Work; aged; arm; cardiometabolic risk; cardiometabolism; cardiorespiratory fitness; cardiovascular disorder risk; cardiovascular fitness; cloud based; cohort; community organizations; coronavirus pandemic; design; disability; effectiveness trial; efficacy study; efficacy/implementation trial; empowerment; evidence base; exercise program; experience; fitness intervention; follow-up; functional disability; high risk; improved; innovation; mortality; mortality risk; novel; participant safety; physical inactivity; physically handicapped; portability; post intervention; pressure; prevent; programs; recruit; scale up; telehealth; telemonitoring

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.

Byron Lai，PhD - R21 项目总结/摘要 由于运动参与率低得惊人，身体残疾儿童的运动参与率相当高， 心血管疾病（CVD）的风险，相关的条件，以及CVD死亡率，因为他们的年龄到成年。 经常参加有氧运动是预防糖尿病的有效非药物方法。 心血管疾病和代谢综合征，但有效的方式，如步行，跑步和骑自行车 通常不适合行动不便的残疾儿童。越来越多的可用性 互联网接入和远程医疗的接受（由于冠状病毒大流行）创造了前所未有的 有机会让大量未得到充分服务的残疾儿童群体参与锻炼行为。然而，在这方面， 确保他们在必要的时间内保持定期参与，以引起变革， 心脏代谢健康将需要令人愉快的、可获得的和适合年龄的计划。本申请 提出了一个试点项目，建立在我们最近的可行性工作。该项目将试行一项以证据为基础， 扩大运动到音乐（M2M）计划，已被新修订的脑瘫儿童谁 都有功能障碍该计划包括三个新颖的组成部分：1）预先录制的视频， 用视觉图形和令人愉快的音乐来风格化主题（例如，超级英雄、体育、流行音乐）， 可行性研究参与者的要求; 2）以手臂为基础的常规短跑强度间歇训练（SIT）， 基于普通人群中最新运动生理学研究的原理; 3）可复制 基于云的远程监控程序参与者将从一家儿童医院和 社区组织。共有50名脑瘫儿童将被随机分为两组： 12周的SIT-M2M或12周的等待名单控制，在接受SIT-M2M之前经历习惯性活动。 SIT处方将包括每周3次，30次重复序列，最大臂为4-s 运动，有积极的恢复期（约20分钟的训练，有热身和冷静期）。本研究将 比较两组之间与心血管健康和核心指标相关的结果的变化， 心脏代谢健康，即身体成分、体重、高敏C反应蛋白、血红蛋白 糖化血红蛋白、甘油三酯、胆固醇和血压。此外，该研究将记录实施指标 这将为后续试验的设计提供信息。研究结果将为制定一项方便的 远程保健功效试验，用于在不同地点和环境中实施，以改善健康和福祉， 这些残疾儿童不能长时间行走或站立。