Telehealth high intensity interval exercise and cardiometabolic health in spinal cord injury

项目摘要 对于患有脊髓损伤(SCI)的人来说，参加运动可以降低患慢性疾病的风险 心脏代谢性疾病，这是导致该人群再次住院和死亡的主要原因。 因此，最近的SCI运动指南强调了运动试验的必要性，这种试验可以改善 心脏代谢因素，如葡萄糖耐量、血脂、血压和身体成分。 然而，到目前为止，检查脊髓损伤心脏代谢结果的运动试验的数量很少，而且 这些运动养生法通常不方便脊髓损伤患者在他们的社区内进行。在……里面 除了与残疾相关的功能损害外，脊髓损伤患者还经历了许多 参与锻炼的障碍，例如缺乏时间(例如，与工作日程冲突)、可获得或可用 设备和设施，以及交通。因此，重要的是确定有效的锻炼模式， 可以改善整体健康，但不需要每周投入大量的总时间。我们最近 证明脊髓损伤患者可以安全地使用ARM进行高强度间歇训练(HIIT 曲柄自行车和每周只需两天的HIIT可以改善心脏代谢健康。尽管 HIIT的优势，重要的是找出能够成功实施运动试验的方法 接触并保持对更大群体的参与。我们团队最近的研究表明，患有 SCI表达了对纳入远程医疗技术的家庭锻炼训练的良好看法， 允许健身专家远程实时监控参与者的训练进度并提供口头 通过视频会议提供支持。这种训练方法对家庭锻炼项目具有更大的价值 这需要监测特定剂量的方案，如HIIT。然而，HIIT的长期成功将 这在很大程度上取决于计划实施的容易程度，以及参与者的坚持性和 对使用该技术的看法，该技术尚未在SCI中进行调查。这项研究的目标是 将家庭远程保健HIIT手臂曲柄运动训练计划整合到SCI患者中并评估 心脏代谢健康和身体功能的变化。次要目标是探索吸收和 HIIT在SCI中的实施。40名参与者将被随机分为两组，一组是基于家庭的HIIT锻炼，另一组是不进行HIIT锻炼 运动对照组为16周。身体成分、有氧健身、肌肉力量和 将在基线和训练后16周对心脏代谢健康进行评估。除了在 心脏代谢的健康结果，我们还将与参与者进行访谈，以确定总体 对程序的感知、程序的好恶、感知的满意度和价值、设备的可用性 和技术，以及影响坚持的因素。

Project Summary For individuals with spinal cord injury (SCI), exercise participation reduces the risk of developing chronic cardiometabolic diseases, which are leading causes of rehospitalization and death within this population. Accordingly, recent SCI exercise guidelines have highlighted a need for exercise trials that can improve cardiometabolic factors such as glucose tolerance, blood lipids, blood pressure, and body composition. However, to date, the number of exercise trials examining these cardiometabolic outcomes in SCI is low, and these exercise regimens are often inconvenient for individuals with SCI to perform within their community. In addition to the functional impairment associated with the disability, individuals with SCI experience a number of barriers to exercise participation, such as lack of time (e.g. conflict with work schedule), accessible or usable equipment and facilities, and transportation. Thus, it is important to identify effective modes of exercise that can improve overall health but do not require a significant overall weekly time commitment. We recently demonstrated that individuals with SCI could safely perform high intensity interval training (HIIT) using arm crank cycling and that as few as two days per week of HIIT could improve cardiometabolic health. Despite the advantages of HIIT, it is important to identify methods of implementing exercise trials that can successfully reach and maintain participation in larger cohorts. Recent work by our group demonstrated that individuals with SCI expressed favorable perceptions of home-exercise training that incorporated telehealth technology, which allowed a fitness specialist to remotely monitor participants' training progress in real-time and provide verbal support via videoconferencing. This method of training holds even greater value for home-exercise programs that require monitoring to dose-specific protocols such as HIIT. However, the long-term success of HIIT will greatly depend on the ease at which the program can be implemented, as well as participants' adherence and perceptions of using the technology, which has not been investigated in SCI. The goal of this study is to integrate a home-based telehealth HIIT arm crank exercise training program in individuals with SCI and assess changes in cardiometabolic health and physical function. The secondary goal is to explore the uptake and implementation of HIIT in SCI. 40 participants will be randomized to home-based HIIT exercise or a no- exercise control group for 16-weeks. Body composition, aerobic fitness, muscular strength, and changes in cardiometabolic health will be assessed at baseline and 16-weeks post training. In addition to changes in cardiometabolic health outcomes, we will also conduct interviews with participants to determine overall perceptions of the program, program likes and dislikes, perceived satisfaction and value, usability of equipment and technology, and factors that influence adherence.