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Feasibility and initial efficacy of a wheelchair exercise-training intervention for persons with multiple sclerosis

对多发性硬化症患者进行轮椅运动训练干预的可行性和初步效果

基本信息

批准号：
10570319
负责人：
Stephanie Silveira Gee
金额：
$ 5.28万
依托单位：
UNIVERSITY OF NORTH TEXAS
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-04-01 至 2023-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10570319
关键词：
Adult Adverse event Aerobic Exercise Attention Behavior Behavioral Body Composition Central Nervous System Cerebral Palsy Cholesterol Chronic Clinical Trials Communities Data Disease Disease Management Disparity Educational Intervention Educational workshop Equipment Exclusion Exercise Fatigue Feedback Fellowship Focus Groups Foundations Functional disorder Future Glucose Glycosylated hemoglobin A Goals Guidelines Health Health Benefit Health Promotion Home Immune Immune System Diseases Insurance Intervention Interview Mediating Medical Care Costs Medical center Mental Depression Metabolic Mission Multiple Sclerosis Nature Needles Neurodegenerative Disorders Occupational Therapy Outcome Pain Participant Pathway interactions Perception Personal Satisfaction Persons Pharmacological Treatment Physical activity Physical therapy Population Prevention Process Productivity Protocols documentation Quality of life Randomized Randomized, Controlled Trials Recommendation Rehabilitation therapy Reporting Research Safety Sample Size Sampling Spinal cord injury Structure Surveys Symptoms Testing Training Programs Transportation Triglycerides United States United States National Institutes of Health Update Wellness Program Wheelchairs White Matter Disease behavior change community engaged research comorbidity cost disability efficacy trial evidence base evidence based guidelines exercise intervention exercise prescription exercise program exercise training experience feasibility testing formative assessment gray matter improved insight interest meetings member multiple sclerosis patient novel physically handicapped preference programs recruit rehabilitation management rehabilitation research satisfaction strength training symptom management symptomatic improvement time use

项目摘要

Project Summary There are an estimated 1 million adults currently living with multiple sclerosis (MS) in the United States. Based on the unique and progressive nature of MS, up to one third of the MS population requires full or part- time use of a wheelchair. Exercise training is identified as a safe, effective second-line therapy for aiding in MS symptom management, however wheelchair users with MS have been excluded from the majority of research investigating the efficacy and promotion of exercise in MS. Wheelchair users with MS are unique from wheelchair users with other chronic disabling conditions such as spinal cord injury and cerebral palsy (e.g., immune system dysfunction and variable disease course), and warrant focal applications of exercise training that suit disease-specific needs and preferences. Novel exercise training programs for wheelchair users with MS would potentially reduce long-term medical costs through improved symptoms, body composition, and overall health (i.e., reduced comorbid conditions). The overarching goal of the proposed research is to obtain feasibility and initial efficacy data for delivering a stakeholder-informed, home-based, remotely-supported and supervised exercise training program among wheelchair users with MS. Our research team initiated a three-step community-engaged research agenda that provided a foundation for the proposed research. First, semi-structured interviews with wheelchair users with MS regarding preferences for exercise training provided a foundation indicating the need for structured, home- based exercise training. Next, we recruited a community advisory board to advise the research team in creating a wheelchair exercise training program. Subsequently, focus group participants provided feedback regarding the appropriateness of the proposed exercise training program materials and delivery to guide final adaptations. This process yielded a novel exercise training program for wheelchair used with MS that will be tested for feasibility and initial efficacy in the proposed study. Twenty-four wheelchair users with MS will be recruited in the Dallas-Fort Worth Metroplex and randomized into exercise training or attention/contact control wellness condition delivered over a 16-week period. The study will assess the feasibility (Specific Aim 1: recruitment, retention, and safety), acceptability (Specific Aim 2: participant satisfaction and perceptions), and scientific outcomes of interest (Specific Aim 3: metabolic health, MS symptoms, and exercise behavior change). If successful, the proposed research will provide critical data for guiding a larger efficacy trial that may substantially move the needle in rehabilitation research and practice for wheelchair users with MS given there are no evidence-based physical activity guidelines for this segment of the MS population. The proposed research is directly aligned with NIH Pathways to Prevention Workshop: Can Physical Activity Improve the Health of Wheelchair Users? and the National Center for Medical Rehabilitation Research Center’s mission of enhancing the health, productivity, independence, and quality of life of people with physical disabilities.

项目总结