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

项目摘要 对于脊髓损伤（SCI）患者来说，运动可以降低患慢性脊髓损伤的风险。 心脏代谢疾病是这一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， 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SCI患者这些心脏代谢结果的运动试验数量很少， 这些锻炼方案对于SCI患者在他们的社区内进行通常是不方便的。在 除了与残疾相关的功能障碍外，SCI患者还经历了许多 参与锻炼的障碍，如缺乏时间（如与工作时间表冲突），可获得或可用 设备和设施以及运输。因此，必须确定有效的锻炼方式， 可以改善整体健康，但不需要每周投入大量的时间。我们最近 研究表明，SCI患者可以安全地进行高强度间歇训练（HIIT）， 曲柄自行车和每周两天的HIIT可以改善心脏代谢健康。尽管 HIIT的优点，重要的是要确定实施运动试验的方法， 在更大的群体中实现并保持参与。我们小组最近的工作表明， SCI表达了对结合远程医疗技术的家庭锻炼培训的良好看法， 允许健身专家实时远程监控参与者的训练进度， 通过视频会议提供支持。这种训练方法对家庭锻炼计划有更大的价值 需要根据剂量特异性方案（如HIIT）进行监测。然而，HIIT的长期成功将 这在很大程度上取决于该计划实施的难易程度，以及参与者的遵守程度， 使用该技术的看法，这在SCI中尚未调查。本研究的目的是 在SCI患者中整合基于家庭远程医疗HIIT手臂曲柄运动训练计划并评估 心脏代谢健康和身体功能的变化。第二个目标是探索吸收和 在SCI中实施HIIT。40名参与者将被随机分配到基于家庭的HIIT锻炼或无 运动对照组16周。身体成分，有氧健身，肌肉力量，以及 将在基线和训练后16周评估心脏代谢健康。除了改变 心脏代谢健康结果，我们还将对参与者进行访谈，以确定总体 对项目的看法，项目的好恶，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.