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

Byron Lai，博士-R21 项目摘要/摘要 由于运动参与率低得令人震惊，肢体残疾儿童的比例相当高 随着年龄的增长，心血管疾病(CVD)、相关疾病和心血管疾病死亡率的风险。 经常参加有氧运动是一种有效的非药物预防方法 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。日益增长的可用性 互联网接入和对远程医疗的接受(由于冠状病毒大流行)创造了前所未有的 让大量缺乏服务的残疾儿童参与锻炼行为的机会。然而， 确保他们在必要的一段时间内保持定期参与，以促使 心脏新陈代谢健康将需要愉快的、可获得的和适合年龄的计划。此应用程序 在我们最近的可行性工作的基础上提出了一个试点项目。该项目将试行一项基于证据的、 为脑性瘫痪儿童新修订的扩大音乐动作(M2M)计划 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 以视觉图形和令人愉快的音乐为主题(例如，超级英雄、体育、流行音乐)进行风格化 2)基于ARM的常规训练和短跑强度间歇训练(SIT)， 基于普通人群中最新运动生理学研究的原理；以及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周的等待名单对照，在接受SIT-M2M之前进行习惯性活动。 SIT处方将包括每周3次，30次重复序列的4-S最大臂 锻炼，有活跃的恢复期(大约20分钟的热身和冷静期)。这项研究将 比较不同组之间与心血管健康相关的结果和核心指标的变化 心脏代谢健康，即身体成分、体重、超敏C反应蛋白、血红蛋白 A1C、甘油三酯、胆固醇和血压。此外，研究还将记录实施指标 这将为后续试验的设计提供信息。研究结果将为开发一种方便的 远程医疗功效试验，在不同地点和环境中实施，以改善健康和健康 残疾儿童长时间不能走路或站立的。

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.