Wheelchair user physical activity training intervention to enhance cardiometabolic health (WATCH): A community-based randomized control trial

轮椅使用者身体活动训练干预以增强心脏代谢健康（WATCH）：一项基于社区的随机对照试验

• 批准号: 10598219
• 负责人: Kerri Ann Morgan
• 金额: $ 53.76万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-01 至 2028-01-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10598219
• 关键词: Address; Adult; Aerobic Exercise; Age; Blood Vessels; Body Composition; Cardiovascular Diseases; Characteristics; Clinical Trials; Collaborations; Communities; Data; Diagnosis; Disease; Education; Educational Intervention; Environment; Equipment; Exercise; Face; Failure; Frequencies; Funding; Future; Gender; General Population; Goals; Guidelines; Health; Health Benefit; Hybrids; Intervention; Knowledge; Laboratories; Measures; Mediator; Metabolic; Modeling; Monitor; Motivation; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Outcome; Pain; Participant; Persons; Physical Function; Physical activity; Population; Positioning Attribute; Protocols documentation; Public Health; Race; Randomized; Randomized, Controlled Trials; Reach, Effectiveness, Adoption, Implementation, and Maintenance; Recommendation; Research; Sample Size; Sampling; Self Efficacy; Stroke; Structure; System; Training Activity; Training Support; United States; Wheelchairs; Work; actigraphy; cardiometabolic risk; cardiometabolism; cardiorespiratory fitness; cardiovascular risk factor; compare effectiveness; disability; evidence base; exercise intervention; experience; health knowledge; high risk; implementation intervention; implementation outcomes; implementation science; improved; intervention effect; moderate-to-vigorous physical activity; obesity risk; participant interview; prevent; primary outcome; programs; sedentary; strength training; success; therapy design; trial comparing

Project Summary: Low levels of physical activity (PA) are common in individuals who use wheelchairs due to physical disability. Wheelchair users (WU) are also at greater risk for obesity and cardiometabolic health-related diseases compared to the general population. Regular PA is widely recognized as being beneficial to the health of persons without a disability and is believed to hold similar benefits for WU. However, WU face barriers to PA, including considerable lack of accessible, community-based facilities, limited access to adapted equipment, lack of knowledge on how to exercise safely, and proper support. Additionally, it is unclear what type of PA intervention is most effective to facilitate WU in achieving current PA recommendations and reversing or preventing cardiometabolic health-related diseases. Thus, evaluating a structured, community-based PA training intervention with education and support is critical and will have significant implications for WU health, future PA guidelines for WU, and the activities of community-based organizations serving WU. The extensive health benefits of aerobic and strength training are well established for the general population, and randomized controlled trials studying the impact of PA for WU suggest programs that provide support and education in accessible, community-based environments are effective for improving outcomes such as strength and pain. However, there is insufficient evidence on whether these interventions result in cardiometabolic health (i.e., VO2peak) improvements in WU. Previous evidence demonstrates these interventions may be inadequate to reach the recommended frequency, intensity, and duration of PA. Preliminary data suggest guiding PA intensity may be essential to improving cardiometabolic health outcomes in WU. The current study proposes a hybrid I randomized controlled trial to test the cardiometabolic effects of a tailored intensity-controlled physical activity training (I PAT) intervention compared to education and access to a community-based accessible gym (EA). The following specific aims will be tested in WU randomized to either the IPAT or the EA intervention groups (N = 54 for both). Specific Aim #1: To compare the effectiveness of the IPAT to EA on cardiorespiratory fitness, vascular function, and body composition. Specific Aim #2: To identify barriers and facilitators to WU engaging in PA at a community-based, accessible gym. Specific Aim #3: To examine the mediators (e.g., self-efficacy) and moderators (e.g., age, race, duration of disability) of the expected intervention effect to understand differences in physiologic response. Moderate-to-vigorous intensity aerobic and strength training will be used to study the effects of interventions delivered in a community-based accessible gym on cardiometabolic related health outcomes such as cardiorespiratory fitness (VO2peak) and vascular function (endothelial function) in WU. Successful completion of the proposed study will generate data to inform future PA guidelines and strengthen the evidence base for safe and effective PA interventions.

项目摘要：由于以下原因，使用轮椅的人体力活动 (PA) 水平较低很常见 身体残疾。轮椅使用者 (WU) 也面临更大的肥胖和心脏代谢健康相关风险 与一般人群相比的疾病。常规 PA 被广泛认为有益于 残疾人的健康，据信对 WU 也有类似的好处。然而，吴脸 PA 的障碍，包括严重缺乏无障碍、以社区为基础的设施、获得适应的机会有限 设备、缺乏如何安全锻炼的知识以及适当的支持。此外，还不清楚是什么 类型的 PA 干预对于促进 WU 实现当前的 PA 建议最有效，并且 逆转或预防心脏代谢健康相关疾病。因此，评估一个结构化的、基于社区的 包括教育和支持在内的 PA 培训干预至关重要，将对 西澳大学健康、西澳大学未来 PA 指南以及为西澳大学服务的社区组织的活动。这 有氧运动和力量训练对普通人群的健康益处已得到充分证实，并且 研究 PA 对 WU 影响的随机对照试验提出了提供支持和帮助的计划 在无障碍、以社区为基础的环境中进行的教育可有效改善以下成果： 力量和痛苦。然而，没有足够的证据证明这些干预措施是否会导致 WU 的心脏代谢健康（即 VO2peak）得到改善。先前的证据证明了这些 干预措施可能不足以达到建议的 PA 频率、强度和持续时间。 初步数据表明指导 PA 强度对于改善心脏代谢健康结果可能至关重要 在吴。目前的研究提出了一项混合 I 随机对照试验来测试心脏代谢的影响 与教育和机会相比，量身定制的强度控制身体活动训练 (I PAT) 干预措施 到基于社区的无障碍健身房 (EA)。以下具体目标将在 WU 中随机测试 IPAT 或 EA 干预组（两者的 N = 54）。具体目标#1：比较有效性 IPAT 到 EA 对心肺健康、血管功能和身体成分的影响。具体目标#2： 确定 WU 在基于社区的无障碍健身房参与 PA 的障碍和促进因素。具体目标#3： 检查中介因素（例如自我效能）和调节因素（例如年龄、种族、残疾持续时间） 预期干预效果以了解生理反应的差异。中等至剧烈强度 有氧和力量训练将用于研究以社区为基础的干预措施的效果 无障碍健身房可提供与心脏代谢相关的健康结果，例如心肺健康 (VO2peak) 和 WU 的血管功能（内皮功能）。成功完成拟议的研究将产生数据 为未来的 PA 指南提供信息，并加强安全有效的 PA 干预措施的证据基础。