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：低水平的体力活动(PA)在使用轮椅的个人中很常见，原因是 身体残疾。轮椅使用者(吴)患肥胖症和心脏代谢健康的风险也更高 与普通人群相比，这些疾病的发病率更高。人们普遍认为有规律的私人助理有益于 非残疾人的健康，据信对吴也有类似的好处。然而，吴面对的是 PA的障碍，包括相当缺乏无障碍的社区设施，适应环境的机会有限 缺乏设备，缺乏如何安全锻炼的知识，以及适当的支持。此外，目前还不清楚 PA干预的类型最有效地促进了WU实现当前PA建议和 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 PA教育和支持的培训干预至关重要，并将对以下方面产生重大影响 吴的健康，未来PA对吴的指导方针，以及为吴服务的社区组织的活动。这个 有氧和力量训练对普通民众的广泛健康益处已经确立，以及 研究PA对吴的影响的随机对照试验建议提供支持和 在可获得的、以社区为基础的环境中进行教育对于改善结果是有效的，例如 力量和痛苦。然而，没有足够的证据表明这些干预是否会导致 心脏代谢健康(即VO2峰值)在吴的改善。先前的证据证明了这些 干预措施可能不足以达到PA的推荐频率、强度和持续时间。 初步数据显示，指导PA强度可能是改善心脏代谢健康结局的关键 在吴国。目前的研究提出了一项混合i随机对照试验，以测试心脏代谢的影响。 与教育和机会相比较的量身定制的强度控制体力活动训练(IPAT)干预 社区无障碍健身房(EA)。以下具体目标将在武汉市随机进行测试 IPAT或EA干预组(N=54)。具体目标1：比较两种方法的有效性 IPAT对电针的心肺功能、血管功能和身体成分的影响。具体目标2： 找出吴在社区无障碍健身房参与PA活动的障碍和促进者。具体目标3： 以检视工作的中介因素(例如自我效能)和调节因素(例如年龄、种族、残疾时间) 预期干预效果以了解生理反应的差异。中等强度到剧烈强度 有氧和力量训练将被用来研究在以社区为基础的 无障碍健身房对心脏代谢相关的健康结果，如心肺健康(VO2峰值)和 吴氏患者的血管功能(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干预的证据基础。